Effect of head position on the efficacy of topical treatment of chronic mucopurulent rhinosinusitis.

Wilson, Robert; Sykes, David A.; Chan, Kwai-Onn; Cole, Peter; Mackay, I. S.

doi:10.1136/thx.42.8.631

Cited by 27 publications

(28 citation statements)

References 5 publications

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“…Significant controversy surrounds optimal head position during sinus irrigation. Numerous papers document the advantage of one head position over others 4, 11, 12. We found that the only sinus impacted by head position was the frontal sinus (Fig.…”

Section: Discussionmentioning

confidence: 68%

Effect of head position and surgical dissection on sinus irrigant penetration in cadavers

et al. 2010

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This study shows that the larger the sinus ostium, the better the penetration of irrigant into the sinus, with an ostium of at least 4.7 mm allowing maximal penetration in the maxillary and sphenoid sinuses. The same benefit was not noted in the frontal sinus. Head position was only relevant to the frontal sinus where less penetration was seen with the head neutral (vertex to ceiling) position when compared to forward angled positions.

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Section: Discussionmentioning

confidence: 68%

Effect of head position and surgical dissection on sinus irrigant penetration in cadavers

et al. 2010

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“…Due to the pressure with which the corticosteroid is applied obstructive lesions in the nasal cavity may be overcome; similar to the headdown-forward position [24].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Chronic Rhinosinusitis with Pressure-Pulsed Corticosteroid Inhalation

Goektas¹,

Lau²

2013

Indian J Otolaryngol Head Neck Surg

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Chronic rhinosinusitis may cause olfactory dysfunction and affects quality of life in patients. In a prospective study we investigated the effect of topical application of corticosteroids through pressure-pulsed inhalation as treatment option of chronic rhinosinusitis with olfactory disorder. Patients with sinonasal olfactory disorder according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) were allocated to the new nasal inhalation therapy or a systemic corticosteroid therapy, each receiving a corticosteroid course of 12 days. 18 patients received topical corticosteroid pressure-pulsed inhalation (AMSA, Schumacher, Dausenau) and 15 systemic corticosteroid. Olfactory function was measured before and after treatment using the Threshold Discrimination Identification score (TDI score) and visual analogue scales. Lund Mackay score (LMS) was measured before starting treatment. Olfactory function (OF) increased from 17.5 ± 6.4 to 21 ± 7.9 TDI points (p \ 0.0005) after 2 months. OF decreased again to 19.5 ± 6.0 after 6 months (p = 0.007). OF increased from 17.0 ± 8.9 to 22.0 ± 9.5 points (p = 0.002) with systemic treatment after 2 months. In the follow-up period of 6 months, the mean TDI score dropped to 20.0 ± 9.2 points (p = 0.01). There was no correlation between LMS and TDI. Treatment of chronic rhinosinusitis with pressure-pulsed inhalation was demonstrated to be effective. Multicenter investigations with large participant numbers are needed.

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“…Topical nasal decongestants are more effective if given with the patient in the “Mecca position,” which should be maintained for two to three minutes (fig 8). 41 Systemic decongestants may provide relief from symptoms but have adverse side effects secondary to (alpha) adrenergic stimulation, such as nervousness, insomnia, tachycardia, and hypertension.…”

Section: Acute Sinusitismentioning

confidence: 99%

Fortnightly Review: Diagnosis and management of sinusitis

Evans

1994

BMJ

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Effect of head position on the efficacy of topical treatment of chronic mucopurulent rhinosinusitis.

Cited by 27 publications

References 5 publications

Effect of head position and surgical dissection on sinus irrigant penetration in cadavers

Effect of head position and surgical dissection on sinus irrigant penetration in cadavers

Treatment of Chronic Rhinosinusitis with Pressure-Pulsed Corticosteroid Inhalation

Fortnightly Review: Diagnosis and management of sinusitis

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