title: Intrasinus administration of topical budesonide to allergic patients with chronic rhinosinusitis following surgery.
abstract: OBJECTIVE
  Whether instillation into the maxillary sinus of topical budesonide affected the immune response and improved allergic patients with chronic rhinosinusitis that had persistence of symptoms despite appropriate surgical intervention was assessed.
  
  
  METHODS
  Double-blind placebo-controlled.
  
  
  METHODS
  Twenty-six patients with allergy to house dust mites who had previously had surgery and who had persistent symptoms of disabling rhinorrhea or pressure-pain resistant to oral antibiotics and intranasal corticosteroids were recruited. During the double-blind study, patients instilled 256 microg budesonide daily or placebo through an intubation device (maxillary antrum sinusotomy tube) into one of the maxillary sinuses for 3 weeks before clinical assessment and a second biopsy.
  
  
  RESULTS
  We found an improvement in the symptom scores in 11 of the 13 patients who received budesonide; we also found a decrease in CD-3 (P = .02) and eosinophils (P = .002), and a decrease in the density of cells expressing interleukin4 (P = .0001) and interleukin-5 messenger RNA (P = .006) after treatment.
  
  
  CONCLUSIONS
  Topical budesonide delivered through a maxillary antrum sinusotomy tube can control chronic rhinosinusitis that persists after surgery.
authors.affiliation: Centre Hospitalier Universitaire de Montréal-Hôspital Nôtre-Dame, McGill University Montréal, Québec, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Lavigne
authors.forename: Lisa
authors.initials: L
authors.lastname: Cameron
authors.forename: Paolo M
authors.initials: PM
authors.lastname: Renzi
authors.forename: Jean François
authors.initials: JF
authors.lastname: Planet
authors.forename: Pota
authors.initials: P
authors.lastname: Christodoulopoulos
authors.forename: Bouchaib
authors.initials: B
authors.lastname: Lamkioued
authors.forename: Qutayba
authors.initials: Q
authors.lastname: Hamid
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D019819:Budesonide / Q000008:administration & dosage*; D002908:Chronic Disease; D004311:Double-Blind Method; D004724:Endoscopy; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007440:Intubation; D008297:Male; D008443:Maxillary Sinus / Q000187:drug effects; D015523:Maxillary Sinusitis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy*; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D012646:Self Administration; D007507:Therapeutic Irrigation
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D019819:Budesonide