Effect of three‐drug delivery modalities on olfactory function in chronic sinusitis. (16th September 2014)

• Record Type: Journal Article
• Authors: Reychler, Gregory; Colbrant, Coralie; Huart, Caroline; Le Guellec, Sandrine; Vecellio, Laurent; Liistro, Giuseppe; Rombaux, Philippe
• Is Part Of: Laryngoscope. Volume 125:Number 3(2015:Mar.)
• Page Start: 549
• Page End: 555
• Publication Date: 2014-09-16
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24937
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24937-sec-0001" sec-type="section"> <title>Background</title> <p>Olfactory dysfunction is deemed to be a significant contributor to poor quality of life in chronic rhinosinusitis (CRS).</p> </sec> <sec id="lary24937-sec-0002" sec-type="section"> <title>Objective</title> <p>To assess and to compare the effectiveness of three modalities of corticosteroids administration in patients with CRS.</p> </sec> <sec id="lary24937-sec-0003" sec-type="section"> <title>Study Design</title> <p>A prospective randomized controlled study</p> </sec> <sec id="lary24937-sec-0004" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="lary24937-sec-0005" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 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 (<italic>P</italic> = 0.231)</p> </sec> <sec id="lary24937-sec-0006" sec-type="section"> <title>Conclusion</title> <p>Effectiveness of sonic nebulized and oral administration is demonstrated on orthonasal olfactory. The clinical benefit is better than with nasal spray.</p> </sec> <sec id="lary24937-sec-0007" sec-type="section"> <title>Level of Evidence</title> <p>1b. <italic>Laryngoscope</italic>, 125:549–555, 2015</p> </sec> </abstract>