title: The use of large volume low pressure nasal saline with fluticasone propionate for the treatment of pediatric acute rhinosinusitis.
abstract: OBJECTIVE
  Fluticasone propionate and nasal saline irrigation have been used in the treatment of sinonasal diseases for a long time. Our study investigates the effect of the combination of large volume low pressure nasal saline irrigation and fluticasone propionate for the treatment of pediatric acute rhinosinusitis.
  
  
  METHODS
  Ninety-one pediatric patients with acute rhinosinusitis were included in our study. The patients were randomized into two groups. The first group (n=45) was treated with standard therapy (antibiotherapy+nasal decongestant) for 2 weeks, the second group was treated with the large volume low pressure nasal saline+fluticasone propionate combination for 3 weeks. The clinical scores, radiologic evaluations (X-ray Waters view), peak nasal inspiratory flow (PNIF) measurements, total symptom scores and hematologic parameters (WBC, CRP, ESR) of the patients were evaluated and compared.
  
  
  RESULTS
  There were no significant differences in between the two groups regarding age, gender, height and weight. Even though the clinical scores of Group 2 improved more rapidly, there were no significant differences in between groups regarding clinical scores by the 21st day. There were no significant differences in post treatment radiologic evaluations (Waters graphy). Both groups had significant improvement of their post treatment PNIF values, yet the improvement was more marked in Group 2 than in Group 1. The rhinorrhea, nasal congestion, throat itching and cough symptoms improved more rapidly in Group 2 than in Group 1. Post-treatment nose itching and sneezing symptoms were significantly less in Group 2. The values of hematologic parameters were significantly reduced at the end of the 3rd week in both groups.
  
  
  CONCLUSIONS
  Our study is a first in investigating the combined use of large volume low pressure nasal saline and fluticasone propionate in acute pediatric rhinosinusitis, and the results reveal that the combination therapy was effective. Low pressure large volume nasal saline+fluticasone propionate combination can be employed as a new line of therapy for the treatment of pediatric acute rhinosinusitis, either by itself or combined with standard therapy.
authors: Bezmialem Vakif University, Faculty of Medicine, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey.
authors: Selahattin
authors: S
authors: Tugrul
authors: Bayrampasa State Hospital, Department of Otorhinolaryngology, Bayrampasa, Istanbul, Turkey. Electronic address: dr.remzidogan@gmail.com.
authors: Remzi
authors: R
authors: Dogan
authors: Bezmialem Vakif University, Faculty of Medicine, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey.
authors: Sabri Baki
authors: SB
authors: Eren
authors: Bezmialem Vakif University, Faculty of Medicine, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey.
authors: Aysenur
authors: A
authors: Meric
authors: Bezmialem Vakif University, Faculty of Medicine, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey.
authors: Orhan
authors: O
authors: Ozturan
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D000068298:Fluticasone; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D001239:Inhalation; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging; D014663:Nasal Decongestants / Q000627:therapeutic use; D055556:Nasal Lavage; D011446:Prospective Studies; D011859:Radiography; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*; D012965:Sodium Chloride / Q000627:therapeutic use*; D065093:beta-Lactamase Inhibitors / Q000627:therapeutic use
chemical_list: D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D007093:Imidazoles; D014663:Nasal Decongestants; D065093:beta-Lactamase Inhibitors; D012965:Sodium Chloride; D019980:Amoxicillin-Potassium Clavulanate Combination; D002097:C-Reactive Protein; D000068298:Fluticasone; C009695:xylometazoline