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Effect of three‐drug delivery modalities on olfactory function in chronic sinusitis
Author(s) -
Reychler Gregory,
Colbrant Coralie,
Huart Caroline,
Le Guellec Sandrine,
Vecellio Laurent,
Liistro Giuseppe,
Rombaux Philippe
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24937
Subject(s) - modalities , chronic sinusitis , sinusitis , olfactory system , medicine , therapeutic modalities , drug , drug delivery , intensive care medicine , pharmacology , surgery , nanotechnology , materials science , psychiatry , social science , sociology
Background Olfactory dysfunction is deemed to be a significant contributor to poor quality of life in chronic rhinosinusitis (CRS). Objective To assess and to compare the effectiveness of three modalities of corticosteroids administration in patients with CRS. Study Design A prospective randomized controlled study Methods Thirty patients with CRS were randomized in three groups depending on the route of corticosteroids administration: 16 days by oral route (Medrol (Pfizer, Belgique), 32 mg/8 days −16 mg/4 days–8 mg/4 days); nasal spray (Rhinocort (AstraZeneca, Belgique), 2 × 2 × 64 µg/nostril); or sonic nebulization (Pulmicort (AstraZeneca, Belgique), 2 × 1 mg/4 mL) (Sonic nebulizer, AOHBOX‐NL11SN, DTF, France). Olfactory function was assessed using orthonasal threshold discrimination identification and retronasal psychophysical olfactory tests (RNT) before and after the treatment. Same intranasal modalities were previously tested for in vitro airways scintigraphic deposition. Results In vitro differences in drug deposition pattern between both intranasal modalities were demonstrated. Threshold discrimination identification and RNT were similar between three groups at baseline. Threshold discrimination identification improved by 5.5, 5.8, and −1.1 for sonic nebulization, oral, and nasal spray groups, respectively ( P = 0.010). This improvement was clinically relevant for oral and nebulized administration. It was similar between oral and nebulized administration but significantly higher than nasal spray administration. Retronasal psychophysical olfactory tests improved similarly for the three groups ( P = 0.231) Conclusion Effectiveness of sonic nebulized and oral administration is demonstrated on orthonasal olfactory. The clinical benefit is better than with nasal spray. Level of Evidence 1b. Laryngoscope , 125:549–555, 2015