title: Effect of three-drug delivery modalities on olfactory function in chronic sinusitis.
abstract: BACKGROUND
  Olfactory dysfunction is deemed to be a significant contributor to poor quality of life in chronic rhinosinusitis (CRS).
  
  
  OBJECTIVE
  To assess and to compare the effectiveness of three modalities of corticosteroids administration in patients with CRS.
  
  
  METHODS
  A prospective randomized controlled study
  
  
  METHODS
  Thirty patients with CRS were randomized in three groups depending on the route of corticosteroids administration: 16 days by oral route (Medrol (Pfizer, Belgique), 32 mg/8 days -16 mg/4 days-8 mg/4 days); nasal spray (Rhinocort (AstraZeneca, Belgique), 2 × 2 × 64 µg/nostril); or sonic nebulization (Pulmicort (AstraZeneca, Belgique), 2 × 1 mg/4 mL) (Sonic nebulizer, AOHBOX-NL11SN, DTF, France). Olfactory function was assessed using orthonasal threshold discrimination identification and retronasal psychophysical olfactory tests (RNT) before and after the treatment. Same intranasal modalities were previously tested for in vitro airways scintigraphic deposition.
  
  
  RESULTS
  In vitro differences in drug deposition pattern between both intranasal modalities were demonstrated. Threshold discrimination identification and RNT were similar between three groups at baseline. Threshold discrimination identification improved by 5.5, 5.8, and -1.1 for sonic nebulization, oral, and nasal spray groups, respectively (P = 0.010). This improvement was clinically relevant for oral and nebulized administration. It was similar between oral and nebulized administration but significantly higher than nasal spray administration. Retronasal psychophysical olfactory tests improved similarly for the three groups (P = 0.231) CONCLUSION: Effectiveness of sonic nebulized and oral administration is demonstrated on orthonasal olfactory. The clinical benefit is better than with nasal spray.
authors.affiliation: Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Gregory
authors.initials: G
authors.lastname: Reychler
authors.forename: Coralie
authors.initials: C
authors.lastname: Colbrant
authors.forename: Caroline
authors.initials: C
authors.lastname: Huart
authors.forename: Sandrine
authors.initials: S
authors.lastname: Le Guellec
authors.forename: Laurent
authors.initials: L
authors.lastname: Vecellio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Liistro
authors.forename: Philippe
authors.initials: P
authors.lastname: Rombaux
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D000328:Adult; D000336:Aerosols; D019819:Budesonide / Q000008:administration & dosage*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D016503:Drug Delivery Systems; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D059085:Nasal Sprays; D009330:Nebulizers and Vaporizers; D000857:Olfaction Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012903:Smell / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D000336:Aerosols; D005938:Glucocorticoids; D059085:Nasal Sprays; D019819:Budesonide
keywords: Nebulizer; deposition; sinus; sinusitis