The effect of intranasal budesonide spray on mucosal blood flow measured with laser Doppler flowmetry.
BACKGROUND
Recent reports have shown that, although rare, findings of mucosal ulcers and perforations of the nasal septum in some cases may be associated with the use of topical nasal glucocorticosteroids (GCS). It can been speculated that, a reduction in septal mucosal blood flow causing ischemia may eventually induce septal perforations.


OBJECTIVE
To evaluate whether a single dose of a potent nasal GCS given in a clinically recommended dose may acutely reduce the mucosal blood flow on the nasal septum.


METHODS
Six healthy subjects received in a randomised double blind placebo controlled crossover procedure one dose of 64 micrograms budesonide aqueous nasal spray (Rhinocort aqua, AstraZeneca R&D, Lund, Sweden) and placebo. One dose was delivered into each nasal cavity by means of a pump spray. As a positive control 140 micrograms of xylometazoline (Nezeril, AstraZeneca R&D, Lund, Sweden) was sprayed in the same way, but in an open fashion. A wash-out period of at least 3 days followed each session. Blood flow was measured on the nasal septum with Laser Doppler flowmetry up to 20 min after administration.


RESULTS
Budesonide did not affect the nasal septal mucosal blood flow as compared to placebo, but xylometazoline reduced the septal mucosal blood flow by 60.9 +/- 7.1% measured from baseline values.


CONCLUSIONS
A single dose of intranasal budesonide aqueous nasal spray has no acute effects on nasal septal mucosal blood flow.
Cervin
A
A
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University of Lund, S-221 85 Lund, Sweden.
Akerlund
A
A
Greiff
L
L
Andersson
M
M
D000281:Administration, Intranasal; D000328:Adult; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D019819:Budesonide / Q000494:pharmacology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology; D017078:Laser-Doppler Flowmetry; D008297:Male; D014663:Nasal Decongestants / Q000494:pharmacology; D009297:Nasal Mucosa / Q000098:blood supply*; D009300:Nasal Septum / Q000098:blood supply*; D012039:Regional Blood Flow / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D007093:Imidazoles; D014663:Nasal Decongestants; D019819:Budesonide; C009695:xylometazoline