title: Topical glucocorticoid reduces the topical decongestant-induced histologic changes in an animal model nasal mucosa.
abstract: OBJECTIVE
  To investigate the histologic consequences of simultaneous nasal glucocorticosteroid and xylometazoline HCl administration in the rabbit nasal mucosa.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  Twenty New Zealand male rabbits were randomly placed into three groups: group I, control (n = 6); group II, xylometazoline HCl (n = 8); or group III, xylometazoline HCl-fluticasone furoate (n = 6). Group I received no treatment. Groups II and III received two intranasal puffs of xylometazoline HCl 0.5 mg/mL twice daily or two puffs of xylometazoline HCl 0.5 mg/mL twice daily plus one puff of 27.5 μg fluticasone furoate twice daily to each nostril (110 μg), respectively. At the end of 3 weeks, the rabbits were sacrificed. The mucosa of the nasal cavities was excised. Specimen sections (5 μm) were stained with hematoxylin and eosin, mucicarmine, and Gomori one-step trichrome and were examined under a light microscope. The presence of edema, congestion, inflammatory cell infiltration, nasociliary loss, epithelial and nerve-ending degeneration, and goblet cell increase were evaluated semiquantitatively (grades 0-3).
  
  
  RESULTS
  Statistically significant differences were detected between groups II and III in terms of edema, congestion, inflammatory cell infiltration, nasociliary loss, and epithelial degeneration (P = .006, P = .049, P = .015, P = .014, and P = .049, respectively). Nerve-ending degeneration, goblet cell increase, and quantitative goblet and neutrophil cell counts did not yield statistically significant differences between groups II and III (P = .137, P = .580, P = .770, and P = .616, respectively).
  
  
  CONCLUSIONS
  The combined simultaneous intranasal administration of xylometazoline HCl and fluticasone furoate appears to be beneficial in minimizing the long-term usage-associated congestion, edema, inflammatory cell infiltration, epithelial degeneration, and nasociliary loss in the rabbit model nasal mucosa.
authors.affiliation: Second Clinic of Otolaryngology Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey. meltemakpinar@hotmail.com
authors.forename: Meltem Esen
authors.initials: ME
authors.lastname: Akpinar
authors.forename: Ozgur
authors.initials: O
authors.lastname: Yigit
authors.forename: Dilek
authors.initials: D
authors.lastname: Akakin
authors.forename: Ozlem
authors.initials: O
authors.lastname: Sarioz
authors.forename: Naziye
authors.initials: N
authors.lastname: Ozkan
authors.forename: Sercan D
authors.initials: SD
authors.lastname: Yildiz
authors.forename: Elad
authors.initials: E
authors.lastname: Azizli
authors.forename: Umit S
authors.initials: US
authors.lastname: Sehirli
mesh_terms: D000281:Administration, Intranasal; D000287:Administration, Topical; D000818:Animals; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D008297:Male; D014663:Nasal Decongestants / Q000633:toxicity*; D009297:Nasal Mucosa / Q000187:drug effects / Q000473:pathology*; D011446:Prospective Studies; D011817:Rabbits; D012220:Rhinitis / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology
chemical_list: D005938:Glucocorticoids; D014663:Nasal Decongestants