Document Detail

Distribution of topical agents to the paranasal sinuses: an evidence-based review with recommendations.
MedLine Citation:
PMID:  23729216     Owner:  NLM     Status:  Publisher    
BACKGROUND: 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 position, and nasal anatomy and to provide evidence-based recommendations. METHODS: A systematic review was conducted using Medline, EMBASE, and Cochrane databases to perform a Medical Subject Heading search of the literature from 1946 until the last week of May 2012. Articles were independently reviewed and graded for level of evidence. All authors came to consensus on recommendations through an iterative process. RESULTS: Recommendations were made for: improved sinus delivery with high-volume devices and after standard sinus surgery. Recommendations were made against low-volume delivery devices, such as drops, sprays, or simple nebulizers as they do not reliably reach the sinuses. If large-volume devices are not tolerated, low-volume devices are recommended using the lying head back or lateral head low positions to improve nasal cavity distribution to the middle meatus or olfactory cleft. CONCLUSION: Surgery, volume of device, head position, and nasal anatomy were shown to impact distribution to the sinuses. Recommendations are made based upon this evidence as to how to best maximize therapeutic distribution to the sinuses.
W Walsh Thomas; Richard J Harvey; Luke Rudmik; Peter H Hwang; Rodney J Schlosser
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-5-31
Journal Detail:
Title:  International forum of allergy & rhinology     Volume:  -     ISSN:  2042-6984     ISO Abbreviation:  Int Forum Allergy Rhinol     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-6-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101550261     Medline TA:  Int Forum Allergy Rhinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 ARS-AAOA, LLC.
Ralph H. Johnson VA Medical Center and Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
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