Effect of Systemic Pretreatment With Betamethasone on the Bacterial Flora, Inflammatory Response, and Polyp Formation in Experimentally Infected Rabbit Maxillary Sinus Mucosa

Norlander, Tomas; Kwon, Sam-Hyun; Henriksson, Gert; Westrin, Karl Magnus; Sandstedt, Karin; Stierna, Pontus

doi:10.1097/00005537-199803000-00018

Cited by 9 publications

(11 citation statements)

References 22 publications

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“…The authors felt that the steroids offered a mucosal protective effect in sinus wound healing. 12 Our study provides additional insight into the use of corticosteroids, specifically in sinusitis therapy. Using the currently accepted animal model for sinusitis, the rabbit, we were consistently able to introduce pseudomonal sinus infections.…”

Section: Discussionmentioning

confidence: 85%

The Effect of Corticosteroids in the Treatment of Experimental Sinusitis

Cable

Wassmuth

Mann

et al. 2000

American Journal of Rhinology

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Emerging evidence indicates that medically recalcitrant sinusitis may be associated with a prolonged and excessive state of inflammation rather than a simple bacterial infection. Corticosteroids have been anecdotally reported to be helpful in treating patients with sinusitis; however, there are no scientific studies documenting the safety and efficacy of corticosteroid therapy in sinusitis. To resolve the controversy over whether corticosteroids promote or inhibit the resolution of sinusitis, we present a prospective study of 80 rabbits with surgically introduced pseudomonal sinusitis that were then treated in one of four arms: control, ceftazidime, methylprednisolone, and ceftazidime with methylprednisolone. Sinus cavities were then evaluated after 5, 14, 21, and 28 days of treatment both by histologic inflammation grading and bacterial quantification. Results showed a significant decrease in bacterial loads in both the antibiotic and antibiotic with steroid arms over control animals, although no difference was seen between the two. Histologic grading showed a similar trend, although statistical significance was not obtained. Overall, this study demonstrated no clear advantage of steroids in the treatment of sinus infections using this model. At the same point, no significant reduction in the effectiveness of antibiotic therapy was seen with concurrent steroid use. A number of limitations of the animal model are noted and the need for human studies in this area is discussed.

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Section: Discussionmentioning

confidence: 85%

The Effect of Corticosteroids in the Treatment of Experimental Sinusitis

Cable

Wassmuth

Mann

et al. 2000

American Journal of Rhinology

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“…We propose that the main reasons for this [21][22][23] are: (1) as an intranasal corticosteroid, budesonide mainly had a focal biological effect on rhinosinus mucosa with lower systemic bioavailability and had no influence on the hypothalamic-pituitary-adrenal axis function; (2) small doses of corticosteroid did not affect the phagocytosis of macrophages. Norlander et al [23] reported about the effect of systemic pretreatment with betamethasone on the bacterial flora, inflammatory response, and polyp formation in experimentally infected rabbit maxillary sinus mucosa, which showed that the amount of macroscopic polyps in animal sinus mucosa decreased significantly in the betamethasone group, and Fig. 8.…”

Section: Discussionmentioning

confidence: 99%

Effects of Intranasal Corticosteroids in the Treatment of Experimental Acute Bacterial Maxillary Sinusitis in Rabbits

You

Hong-qi²,

Li³

et al. 2008

ORL

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Objective: To investigate the possible effects of intranasal corticosteroids on the focal bacterial colonization and mucosal histomorphological changes in experimental acute bacterial maxillary sinusitis in rabbits. Methods: Acute bacterial maxillary sinusitis was induced in 48 rabbits. They were divided into 4 groups: antibiotic group (group A), antibiotic and corticosteroid combination group (group B), corticosteroid group (group C), and control group (group D). Six rabbits in each group were sacrificed to obtain secretions from the maxillary sinuses for bacterial culture after they had been treated for 2 or 4 weeks. Maxillary sinuses were removed for whole-mount histological analysis. Results: The differences between bacterial culture ratios in groups A and B compared with groups C and D were significant after treatment for 4 weeks (p < 0.05), but there was no significant difference between groups A and B (p > 0.05). Semi-quantitative analyses showed that epithelial ulceration and ciliary loss in groups A and B were less pronounced than that in groups C and D (p < 0.05). Infiltration by inflammatory cells diminished more significantly in group B than in groups C and D (p < 0.05). A significant difference in inflammatory cell infiltration between groups A and B was found at the fourth week (p < 0.05). Ultrastructural changes showed a similar trend in both group A and group B. Conclusions: Intranasal corticosteroids may lessen infiltration by inflammatory cells, and their combined application does not decrease the effects of antibiotic therapy in our study. In the treatment of acute bacterial maxillary sinusitis, intranasal corticosteroids cannot be a substitute for antibiotic treatment as a single therapy, but intranasal corticosteroids administered with antibiotics provide better efficacy.

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“…15 In another study, systemic pretreatment with betamethasone in experimentally infected rabbit maxillary sinus mucosa reduced inflammatory response, polyp formation, and pathogenic strains. 16 The use of fluticasone dipropionate aqueous nasal spray for the postoperative control of recurrent nasal polyps seemed to be associated with a higher incidence of acute pansinusitis than beclomethasone dipropionate spray. 17 There are only a few studies of the effect of topical nasal steroids on MCC.…”

Section: Discussionmentioning

confidence: 99%