Our Summary

This study was designed to figure out how well a certain type of nasal spray, a corticosteroid one, reaches different parts of the nose and sinus cavity. This is especially important for people who have had surgery for chronic sinusitis, a condition where the sinuses are inflamed for a long time.

To do this, the researchers used a nasal spray with a special blue dye in it on 51 patients who had recently had sinus surgery. They then used a medical imaging technique called endoscopy to see where the spray ended up.

They also used a model of the sinus and nasal cavities to track where the spray ended up. In this model, they used a red dye instead of the blue one.

They found that the spray was able to efficiently reach the ethmoid sinus, which is located between the eyes, and the olfactory cleft, the part of the nasal cavity that is responsible for smell. This was true in both the patients and the model.

This suggests that the nasal spray could be an effective way of delivering medication to these parts of the sinus and nasal cavities after surgery.

FAQs

  1. How was the deposition pattern of corticosteroid nasal spray evaluated in the study?
  2. What were the predominant areas of the spray deposition in the operated sinonasal cavities?
  3. Did the corticosteroid nasal spray efficiently reach the olfactory cleft and the ethmoid sinus in post-operative conditions?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sinus surgery is to properly use corticosteroid nasal spray after the procedure. The spray should be aimed towards the ethmoid sinus and olfactory cleft to ensure effective medication delivery to those areas. It is important to follow the doctor’s instructions on how to use the nasal spray to maximize its benefits in post-operative conditions.

Suitable For

Patients who are typically recommended sinus surgery include those with chronic rhinosinusitis that has not responded to other treatments, such as nasal corticosteroid sprays, antibiotics, and nasal saline irrigation. Other potential candidates for sinus surgery may include patients with nasal polyps, deviated septum, or structural abnormalities in the sinuses that are causing recurrent sinus infections or difficulty breathing. Ultimately, the decision to recommend sinus surgery is made on a case-by-case basis by an otolaryngologist after a thorough evaluation of the patient’s symptoms and medical history.

Timeline

Before sinus surgery:

  • Patient experiences chronic rhinosinusitis symptoms such as nasal congestion, facial pain, headache, and post-nasal drip.
  • Patient may undergo medical treatments such as antibiotics, nasal steroid sprays, and decongestants.
  • If symptoms do not improve with medical treatment, patient may be recommended for sinus surgery.

After sinus surgery:

  • Patient undergoes endoscopic sinus surgery to remove blockages and improve sinus drainage.
  • Patient may be prescribed corticosteroid nasal spray for post-operative care.
  • Deposition patterns of the nasal spray in the sinonasal cavity are evaluated through endoscopy and video documentation.
  • Predominant areas of spray deposition are observed in the ethmoid sinus and olfactory cleft in post-operative conditions.
  • Corticosteroid nasal spray efficiently reaches the olfactory cleft and ethmoid sinus, as demonstrated by post-operated human cases and a computed tomography-based sinonasal airway model.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sinus surgery include:

  1. How will sinus surgery improve my symptoms of chronic rhinosinusitis?
  2. What are the potential risks and complications of sinus surgery?
  3. What is the recovery process like after sinus surgery?
  4. Will I need to take any medications or use nasal sprays after sinus surgery?
  5. How long will it take for me to see improvement in my symptoms after sinus surgery?
  6. Will I need any follow-up appointments or additional treatments after sinus surgery?
  7. How long do the effects of sinus surgery typically last?
  8. Are there any lifestyle changes or precautions I should take after sinus surgery?
  9. How can I best care for my sinuses post-surgery to prevent complications or infection?
  10. Are there any alternative treatments or therapies that may be effective for my chronic rhinosinusitis instead of surgery?

Reference

Authors: Ikeda K, Harashima T, Koike T. Journal: Am J Otolaryngol. 2021 Nov-Dec;42(6):103058. doi: 10.1016/j.amjoto.2021.103058. Epub 2021 Apr 16. PMID: 33932624