Intrasinus administration of topical budesonide to allergic patients with chronic rhinosinusitis following surgery.
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.
Lavigne
François
F
Centre Hospitalier Universitaire de Montréal-Hôspital Nôtre-Dame, McGill University Montréal, Québec, Canada.
Cameron
Lisa
L
Renzi
Paolo M
PM
Planet
Jean François
JF
Christodoulopoulos
Pota
P
Lamkioued
Bouchaib
B
Hamid
Qutayba
Q
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
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D019819:Budesonide