title: Techniques of intranasal steroid use.
abstract: OBJECTIVE
  The effectiveness of topical intranasal steroids (INS) sprays for the treatment of allergic and nonallergic rhinitis may be limited by lack of instruction in the optimal spray technique. To determine whether the technique used affects the efficacy and safety of the product, this review of evidence had the goal of identifying and establishing a preferred method of applying INS sprays.
  
  
  METHODS
  A MEDLINE search of pertinent literature on 7 INS and 1 intranasal antihistamine spray preparations conducted with the use of appropriate search terms, yielded an initial 121 articles, 29 of which were identified as appropriate for review and grading for quality of evidence.
  
  
  RESULTS
  The analysis provided no definitive evidence regarding how best to instruct patients to use INS or antihistamine spray devices.
  
  
  CONCLUSIONS
  On the basis of a lack of clear evidence regarding instructions to maximize efficacy and safety of these drugs, the panel recommended a 7-step standard technique.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA. MBENNING@hfhs.org
authors.forename: Michael S
authors.initials: MS
authors.lastname: Benninger
authors.forename: James A
authors.initials: JA
authors.lastname: Hadley
authors.forename: J David
authors.initials: JD
authors.lastname: Osguthorpe
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Marple
authors.forename: Donald A
authors.initials: DA
authors.lastname: Leopold
authors.forename: M Jennifer
authors.initials: MJ
authors.lastname: Derebery
authors.forename: Maureen
authors.initials: M
authors.lastname: Hannley
mesh_terms: D000281:Administration, Intranasal; D004844:Epistaxis / Q000209:etiology; D019317:Evidence-Based Medicine; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D012220:Rhinitis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids