title: Topical Therapies for Refractory Chronic Rhinosinusitis.
abstract: Topical therapy has become an important tool in the otolaryngologist's armamentarium for refractory chronic rhinosinusitis (CRS). Daily high-volume sinonasal saline irrigation and standard metered-dose topical nasal steroid therapy are supported by the most evidence. Nonstandard topical sinonasal steroid therapies are a potential option for refractory CRS. Current evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using spray and nebulized techniques in routine cases of CRS. Stents are a new modality with preliminary data showing they are an option when traditional treatment has failed. Further research with long-term effects and outcomes studies for refractory CRS are needed.
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Akshay
authors.initials: A
authors.lastname: Sanan
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Mindy
authors.initials: M
authors.lastname: Rabinowitz
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Rosen
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Electronic address: Gurston.Nyquist@Jefferson.edu.
authors.forename: Gurston
authors.initials: G
authors.lastname: Nyquist
mesh_terms: D000287:Administration, Topical; D002908:Chronic Disease; D006801:Humans; D054539:Medication Therapy Management; D009297:Nasal Mucosa / Q000187:drug effects*; D012220:Rhinitis / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D012852:Sinusitis / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: Anti-inflammatory; Antimicrobial; Chronic rhinosinusitis; Stents; Surfactant; Topical therapy