Tolerability of N-chlorotaurine in chronic rhinosinusitis applied via yamik catheter.
OBJECTIVE
A rational approach in the treatment of chronic rhinosinusitis (CRS) is the intranasal application of antiseptic agents, due to the pathogenetic role of bacteria and fungi. N-Chlorotaurine (NCT), a mild endogenous oxidant with broad-spectrum antimicrobial activity, has been tested for the first time in CRS.


METHODS
This one-arm phase IIa clinical study is the first step in the clinical development of this promising substance for local therapy of CRS. The nasal and paranasal cavities of 12 patients were rinsed with 10-20 ml of 1% aqueous NCT solution, applied via a novel catheter system (YAMIK). Treatment consisted of three lavages per week for 4 weeks.


RESULTS
NCT caused neither alterations of the mucosa nor burning pain during application. Nevertheless, the insertion of the catheter, the insufflation of the posterior cuff and the overpressure inside the sinuses after infiltration led to moderate pain in some patients. Mucosal swelling decreased in all subjects, nasal breathing could be improved in nine patients and impaired olfaction in seven. Polyps did not disappear within the 1-month period of the study.


CONCLUSIONS
The good tolerability and possible beneficial effects of NCT encourage its further investigation in CRS. Despite some limitations the YAMIK catheter proved to be a convenient and safe device for rinsing the nasal and paranasal sinuses.
Neher
Andreas
A
Department of Otorhinolaryngology, Innsbruck Medical University, Anichstr. 35, Innsbruck, Austria. Andreas.Neher@uibk.ac.at
Fischer
Hannes
H
Appenroth
Elisabeth
E
Lass-Flörl
Cornelia
C
Mayr
Astrid
A
Gschwendtner
Andreas
A
Ulmer
Hanno
H
Gotwald
Thaddaeus F
TF
Gstöttner
Michaela
M
Kozlov
Vladimir
V
Nagl
Markus
M
D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002404:Catheterization / Q000295:instrumentation; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012852:Sinusitis / Q000188:drug therapy*; D013053:Spectrophotometry; D013654:Taurine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007507:Therapeutic Irrigation
D000890:Anti-Infective Agents; D013654:Taurine; C043410:N-chlorotaurine