Topical therapies in the management of chronic rhinosinusitis: an evidence‐based review with recommendations

  title={Topical therapies in the management of chronic rhinosinusitis: an evidence‐based review with recommendations},
  author={Luke R Rudmik and Monica Y Hoy and Rodney J. Schlosser and Richard J. Harvey and Kevin C. Welch and Valerie J. Lund and Timothy L. Smith},
  journal={International Forum of Allergy \& Rhinology},
  pages={281 - 298}
Topical therapies have become an integral component in the management plan for chronic rhinosinusitis (CRS). Several topical therapy strategies have been evaluated, but a formal comprehensive evaluation of the evidence has never been performed. The purpose of this article is to provide an evidence‐based approach for the utilization of topical therapies in the management of CRS. 

Topical antibiotic therapy in chronic rhinosinusitis: an update

Recent clinical research published since society guidelines and evidence‐based medicine reviews recommended against the use of topical antibiotic therapy based on randomized controlled trials is reviewed.

Future topical medications in chronic rhinosinusitis

The goal of this review is to summarize and discuss the potential and pitfalls of topical medications in the treatment of CRS.

Medical management of chronic rhinosinusitis – an update

A comprehensive, up to date analysis of the literature concerning the medical management of Chronic rhinosinusitis is provided by highlighting the most recent evidence based recommendations addressing this ongoing field of research.

Medical management of chronic rhinosinusitis – a review of traditional and novel medical therapies

A comprehensive, up to date analysis of the literature concerning the medical management of Chronic rhinosinusitis is provided by summarizing the evidence in support of traditional medical therapies for the management of CRS in addition to highlighting novel medical therapies currently under investigation.

Topical corticosteroid irrigations in chronic rhinosinusitis

The purpose in this study was to evaluate the efficacy and safety of topical corticosteroid treatment in chronic rhinosinusitis.

Distribution of topical agents to the paranasal sinuses: an evidence‐based review with recommendations

The objective of this work was to review the literature concerning the distribution of topical therapeutics to the sinuses versus nasal cavity regarding: surgical state, delivery device, head

A Practical Approach to Refractory Chronic Rhinosinusitis.

Latest developments on topical therapies in chronic rhinosinusitis.

  • N. TanA. Psaltis
  • Medicine
    Current opinion in otolaryngology & head and neck surgery
  • 2019
Topical steroids delivered in conjunction with saline nasal irrigation offer the best combination of treatments in CRS and should be considered a standard of care.

Impact of continued medical therapy in patients with refractory chronic rhinosinusitis

Patients with refractory chronic rhinosinusitis who have significant reductions in baseline disease‐specific quality of life (QoL) and would be considered candidates for endoscopic sinus surgery (ESS) are evaluated.

Pharmacological Management of Chronic Rhinosinusitis: Current and Evolving Treatments

The pathophysiology of CRS is described, both established and novel biologic pharmacologic treatments are summarized and the cost of these therapies compared with the benefit they provide are assessed.



Impact of topical nasal steroid therapy on symptoms of nasal polyposis

The objective of this study was to determine the impact of topical steroid therapy on nasal symptoms in patients with nasal polyposis.

The effect of topical amphotericin B on inflammatory markers in patients with chronic rhinosinusitis: A multicenter randomized controlled study

It has been suggested that an exaggerated immune response to fungi is crucial in the pathogenesis of chronic rhinosinusitis (CRS). Based on this rationale, the use of topical antifungals

What is the role of long‐term macrolide therapy in the treatment of recalcitrant chronic rhinosinusitis?

Long-duration therapy with macrolide antibiotics for the treatment of recalcitrant chronic rhinosinusitis based on the unique anti-inflammatory properties of macrolides rather than a strict antibacterial effect is advocated.

Topical Steroid for Chronic Rhinosinusitis without Polyps

  • M. BurtonM. RyanR. Rosenfeld
  • Medicine
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 2012
A Cochrane Review finds good evidence to support therapeutic benefits with no increase in adverse events compared with placebo controls for Chronic Rhinosinusitis without Polyps.

Nasal Lavage With Mupirocin for the Treatment of Surgically Recalcitrant Chronic Rhinosinusitis

The efficacy and tolerability of topical mupirocin for the management of surgically recalcitrant chronic rhinosinusitis associated with Staphylococcus aureus infection is examined.

Topical Antimicrobials in the Management of Chronic Rhinosinusitis: A Systematic Review

Topical antibiotics appear effective in the management of CRS, but larger and better-designed randomized double-blind placebo-controlled trials are required to more fully evaluate this emerging modality of treatment.

Macrolide Therapy for Chronic Rhinosinusitis

There is limited scientific evidence to support the use of long-term macrolide therapy for chronic rhinosinusitis, and further clinical research is needed to determine whether there may be a subgroup effect based on the underlying inflammatory disease process.

Xylitol nasal irrigation in the management of chronic rhinosinusitis: A pilot study

To determine the tolerability of xylitol mixed with water as a nasal irrigant and to evaluate whether xylitol nasal irrigation results in symptomatic improvement of subjects with chronic

Topical Steroids in Chronic Rhinosinusitis Without Polyps: A Systematic Review and Meta-Analysis

A systematic review of the use of intranasal steroids in the treatment of chronic rhinosinusitis