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Comparaison de trois modes d'administration de corticoïdes dans le traitement de la rhinosinusite chronique avec ou sans polypes
Congrès de la société Belge d'ORL, puis ERS/ISIAN (25th congress of European Rhinology Society & 32th International Symposium of Infection & Allergy of the Nose), Amsterdam (Pays Bas), ERS Munich 2014, SFORL Paris 2014.
Auteurs : Coralie Colbrant, Gregory Reychler, Caroline Huart, Sandrine Le Guellec, Laurent Vecellio, Philippe Rombaux
Objectives: Olfactory dysfunction is deemed to be a significant contributor to poor quality of life in chronic rhinosinusitis (CRS). This study was undertaken assess the effectiveness of three modalities of corticosteroids administration in patients with CRS. Secondly, to compare modalities between themselves and the effects on olfactory function changes.
Methods: A cohort of 30 patients with CRS (aged from 18 to 72 years) were reccruited and randomized in three groups depending on the route of corticosteroids administration. Corticosteroids were administrated during 16 days by oral, nasal spray or nebulized route. Olfactory function was assessed using orthonasal (TDI) and retronasal psychophysical olfactory (RETRO) tests at inclusion and after the treatment.
Results: TDI and RETRO were similar between three groups at baseline. TDI improved by 5.5, 5.8 an -1.1 for sonic nebuluzation, oral and nasal spray groups respectively. This improvement was significantly different between modalities and only clinically relevant for oral and nebulized administration. It was similar between oral and nebulized administration but significantly higher than nasal spray administration. RETRO improved by 1.1, 4.2 and 0.7 for sonic nebuluzation, oral and nasal spray groups respectively.
Conclusion: Effectiveness of nebulized and oral administration is demonstrated on orthonasal olfactory. The benefit is better than with nasal spray. Changes in olfactory function can be demonstrated with psychiophysical testing.
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