pulmicort and Nasal-Obstruction

To highlight a severe case of rhinotillexomania (compulsive nasal picking) and its potential to manifest as empty nose syndrome (ENS).. A single case report with the presentation and management of a patient with severe rhinotillexomania who presented with chronic obstructive symptoms. We review the current literature on rhinotillexomania and ENS.. This patient's manifestations mimic the obstructive symptoms of ENS, despite widely patent nasal passages.. This is the first report of rhinotillexomania manifesting with features of ENS.

Topics: Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Budesonide; Compulsive Behavior; Endoscopy; Humans; Humidifiers; Male; Mupirocin; Nasal Obstruction; Nasal Septal Perforation; Nose Diseases; Syndrome; Therapeutic Irrigation; Tomography, X-Ray Computed

Topics: Administration, Topical; Anti-Inflammatory Agents; Budesonide; Endoscopy; Glucocorticoids; Humans; Image Processing, Computer-Assisted; Nasal Mucosa; Nasal Obstruction; Nasal Polyps; Paranasal Sinus Diseases; Pregnenediones; Wound Healing

It is not unequivocally proven whether a combination of an intranasal corticosteroids (INSs) and a cysteinyl leukotriene receptor antagonist has greater efficacy than INSs in the treatment of seasonal allergic rhinitis (SAR).. Single-center, randomized, open-label study.. Study subjects included 46 participants with SAR. Participants were randomized to receive budesonide (BD; 256 μg) plus montelukast (MNT; 10 mg) (BD + MNT) or BD alone (256 μg) for 2 weeks. Visual analog scale scores for five major symptoms of SAR, nasal cavity volume (NCV), nasal airway resistance (NAR), and fractional exhaled nitric oxide (FeNO) were assessed before and at the end of treatments.. Both treatments significantly improved the five main SAR symptoms from baseline; however, BD + MNT produced significantly greater improvements in nasal blockage and nasal itching compared to BD alone. At baseline, the nasal blockage score was significantly correlated with NCV and NAR (r = -0.473, P = .002 and r = -0.383, P = .013, respectively). After 2 weeks of treatment, BD + MNT significantly improved NCV, but not NAR, to a greater level than BD. The number of patients with FeNO concentration ≥ 30 ppb at baseline was significantly decreased after BD + MNT treatment, but not after BD treatment. Similarly, BD + MNT treatment led to a significantly greater decrease in FeNO concentration than BD treatment.. BD + MNT treatment may have an overall superior efficacy than BD monotherapy for patients with SAR, especially in improvement of nasal blockage, itching, and subclinical lower airway inflammation. Also, NCV and NAR could be used to assess nasal blockage more accurately.. 1b Laryngoscope, 131:E1054-E1061, 2021.

Topics: Acetates; Administration, Intranasal; Adult; Bronchodilator Agents; Budesonide; China; Cyclopropanes; Drug Therapy, Combination; Female; Humans; Leukotriene Antagonists; Male; Nasal Obstruction; Quinolines; Rhinitis, Allergic; Sulfides

Topics: Administration, Intranasal; Budesonide; Child; Double-Blind Method; Eosinophils; Female; Glucocorticoids; Humans; Male; Nasal Obstruction; Nitric Oxide; Rhinitis, Allergic, Perennial; Sleep

Although it is anecdotally known that nasal obstruction is associated with snoring, it remains unknown whether the application of nasal steroids could decrease oral/oro-nasal breathing and increase nasal breathing, and subsequently decrease snoring indices. This study evaluated the effect of nasal budesonide on breathing route pattern and snoring. Twenty-four snorers were enrolled in a randomized, double-blind, crossover trial of 1-week treatment with nasal budesonide compared with 1-week intervention with nasal placebo. At the start and end of each treatment period, patients underwent nasal resistance measurement and overnight polysomnography with concomitant measurement of breathing route pattern and snoring. Twelve patients were randomly assigned to a 1-week treatment with nasal budesonide, followed by 2-week washout period and a 1-week intervention with the nasal placebo; and 12 patients were randomly assigned to a 1-week intervention with nasal placebo, followed by 2-week washout period and a 1-week treatment with nasal budesonide. Nasal budesonide was associated with a decrease in oral/oro-nasal breathing epochs and concomitant increase in nasal breathing epochs, decrease of snoring frequency by [median (interquartile range)] 15.8% (11.2-18.8%), and an increase of rapid eye movement sleep; snoring intensity decreased only in patients with increased baseline nasal resistance by 10.6% (6.8-14.3%). The change in nasal breathing epochs was inversely related to the change in snoring frequency (Rs = 0.503; P < 0.001). Nasal budesonide in snorers can increase nasal breathing epochs, modestly decrease snoring frequency and increase rapid eye movement sleep.

Topics: Administration, Intranasal; Adult; Budesonide; Cross-Over Studies; Double-Blind Method; Female; Humans; Male; Nasal Obstruction; Polysomnography; Respiration; Sleep, REM; Snoring

Intranasal steroids are recognized as an effective treatment for allergic rhinitis (AR) although their effect on nasal patency has never been evaluated with an objective instrument such as anterior rhinomanometry in children. Moreover this effect has been widely assessed with total Nasal Symptom Scores (NSS) including all symptoms of allergic rhinitis and not with scores specifically focused on nasal obstruction such as the Nasal Obstruction Symptom Evaluation score (NOSE).. Sixty children (42 males and 18 female) aged 6-10 years, affected by persistent AR, were randomized and divided in two groups of 30 children to be included in an unblinded trial: one group treated with intranasal budesonide and isotonic nasal saline for 2 weeks and the other group treated only with isotonic nasal saline for 2 weeks. Each child underwent rhinomanometry and completed the NSS and the NOSE scores before and after treatment.. At the baseline nasal patency and NSS total score, NOSE total scores were correlated (r=-0.29, p<0.001; r=-60, p<0.001). After 2 weeks of treatment improvements in nasal patency, NSS and NOSE were seen (Δ NSS 4.13 ± 1.38 vs 1.33 ± 1.93, p<0.001; Δ NOSE 34 ± 17.97 vs 9 ± 18.21, p<0.001; Δ nasal patency -26.13 ± 25.25 vs -11.83 ± 11.31, p<0.001). Correlations were found between rhinitis duration and Δ nasal patency and Δ NOSE (r=-0.84, p<0.001; r=0.43, p<0.01).. Intranasal budesonide is effective in increasing nasal patency in children. Moreover the NOSE score was strongly correlated with nasal flow and, hence, this score should be regarded as a valid and reliable instrument in children.

Topics: Administration, Intranasal; Budesonide; Child; Female; Glucocorticoids; Humans; Male; Nasal Obstruction; Rhinitis, Allergic; Rhinomanometry; Symptom Assessment; Treatment Outcome

To evaluate the efficacy and safety of a short course of nebulized budesonide via transnasal inhalation in chronic rhinosinusitis with nasal polyps.. Fifty patients with severe eosinophilic nasal polyps were randomized devided into study group (n = 25) and control group (n = 25). The study group received budesonide inhalation suspension (1 mg twice daily) via transnasal nebulization for one week and the control group received oral prednisone (24 mg QD). Visual analogue scales (VAS) of nasal symptoms, endoscopic polyp scores (kennedy scores) and morning serum cortisol concentrations were assessed in both groups pre- and post-treatment. Operation time and surgical field bleeding were evaluated.. Four subjects dropped out in control group. Budesonide transnasal nebulization caused a significant improvement in all nasal symptoms especially nasal obstruction (baseline: 8.25 ± 0.53; after treatment: 4.97 ± 0.97, P < 0.01) and reduced polyp size significantly (baseline: 4.64 ± 0.63; after treatment: 3.40 ± 0.76, P < 0.01) compared to pre-treatment. The patients treated with oral prednisone, however, showed more obvious improvement in nasal symptoms and polyp size, shorter operation time and better surgical field than budesonide group. Additionally, the morning serum cortisol concentration was mildly decreased after one week treatment in budesonide group [baseline (17.18 ± 2.83) μg/dl, after treatment (16.24 ± 2.93) μg/dl, P > 0.05], but all values were still located in normal range (normal range: 5-25 μg/dl). Conversely, the morning serum cortisol concentration in oral prednisone group was lower than normal limit [baseline (18.19 ± 2.81) μg/dl, after treatment (2.26 ± 0.70) μg/dl, P < 0.01].. Twice daily budesonide transnasal nebulization is an effective and safe treatment as evidenced by significant improvements in nasal symptoms and reduction in polyp size, coupled with an absence of hypothalamic-pituitary-adrenal axis suppression, which is safer than the systemic corticosteroids. Budesonide transnasal nebulization offers a viable treatment option for CRSwNP before operation.

Topics: Administration, Inhalation; Budesonide; Chronic Disease; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Nasal Obstruction; Nasal Polyps; Pituitary-Adrenal System; Prednisone; Rhinitis; Sinusitis; Suspensions

To investigate the clinical effect of nasal packing of pulmicort respules combined withnasopore after endoscopic sinus surgery.. A total of 30 CRSwNP and CRSsNP patients with bilateral functional endoscopic sinus surgery and finished following up visit were randomly choosed, conventionally select the left nasal cavity as the experimental group, the right nasal cavity as the control group. Experimental group to pack the nasal cavity with pulmicort respules union nasopore after surgery and control group to pack the nasal cavity with only nasopore after surgery. The differences were observed in patients with subjective symptoms and recovery of mucosa of operative cavity between the two groups after two weeks, one month and three months.. (1) The postoperative VAS symptoms score about nasal obstruction, nasal secretion, headache, dizziness and distending pain after two weeks,one month and three months in the experiment group were significantly better than those in the control group(P<0.05). (2) The postoperative Lund-Kennedy endoscopic mucosa morphology score after two weeks, one month and three months in the experiment group were significantly better than those in the control group(P<0.05); (3) After three months, the experiment group had 28 cases with clinic symptoms cured(93. 3%), Total effective rate was 96. 6%; The control group had 22 cases with clinic symptoms cured (73. 3%), total effective rate was 93. 3%. The cure rate of the experiment group was significantly higher than the control group(P<0.05), but there was no statistic difference between the two groups in the total effective rate (P>0.05).. The application of nasal packing of pulmicort respules combined with nasopore after functional endoscopic sinus surgery can effectively relieve postoperative uncomfortable symptoms, promote recovery of mucosa of perative cavity, which deserves clinical promotion.

Topics: Anti-Inflammatory Agents; Bandages; Budesonide; Endoscopy; Epistaxis; Humans; Nasal Cavity; Nasal Obstruction; Paranasal Sinuses; Postoperative Period

The objective of the present study was to evaluate the clinical response to topical budesonide in patients with nasal polyposis (NP) and to evaluate if there is any clinical event that may predict the response to treatment. Twenty patients with NP were assessed by a clinical questionnaire, nasal endoscopy and sinusal computed tomography. The patients were then medicated with budesonide, 256 microg/nostril/day, for a 2-month period and afterwards they were submitted to a new clinical questionnaire and a new endoscopy. Post-treatment endoscopy revealed a significant reduction of polyp size's score (4.25 vs. 2.90, p < 0.01), which was associated to improvement of nasal symptoms: posterior rhinorrhea, headache, hyposmia, anterior rhinorrhea, and sneezing (p < 0.05). There was also a significant improvement of the sum of scores (20.10 vs. 10.30, p < 0.0001). Cacosmia and nasal itching did not respond to medical treatment. Patients with a higher tomographic extension of the polyp presented a significantly worse clinical response (p < 0.05). We conclude that there was partial, but significant, improvement of nasal symptoms and polyp size after treatment with nasal budesonide and that this clinical improvement was inversely correlated to the tomographic extension of NP at diagnosis.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Budesonide; Endoscopy; Female; Glucocorticoids; Headache; Humans; Male; Middle Aged; Nasal Obstruction; Nasal Polyps; Olfaction Disorders; Paranasal Sinuses; Remission Induction; Rhinitis; Sneezing; Surveys and Questionnaires; Tomography, X-Ray Computed; Treatment Outcome

While it is widely accepted that inhaled glucocorticosteroids represent an effective treatment for allergic rhinitis, little is known on the specific effects of this therapeutic approach in other upper airway disorders of childhood. The aim of the study was to evaluate the improvement of clinical symptoms and changes in local cellular inflammatory reaction induced by budesonide inhalation suspension in children with recurrent nasal infections using budesonide inhalation suspension delivered by Rinowash, a nebulizer designed to treat upper airway structures.. In a randomized, controlled-open study, 14 children (5.88+/-0.56 years of age) with recurrent upper airway infections and chronic nasal obstruction were enrolled and randomly treated for 7-10 days either with budesonide inhalation suspension (250 microg/bidie) (nine patients) or with saline solution (five patients). Before and after treatment, inflammatory cells in nasal brushing and nasal symptom score were evaluated.. Out of the nine patients treated with budesonide, two were excluded from the analysis because of acute respiratory infections requiring systemic antibiotic treatment. A significant decrease in nasal brushing neutrophil percentage was observed after treatment with budesonide (P=0.016) but not after saline solution treatment (P=1.00). No significant changes in nasal brushing mononuclear cell or eosinophil proportions were observed after treatment with budesonide inhalation suspension or saline solution (P=NS, each comparison). Treatment with budesonide, but not with saline solution, was associated with a significant reduction in nasal obstruction (P=0.016).. These preliminary data indicate that short-term treatment with budesonide inhalation suspension, used for an indication out of label, may significantly reduce local neutrophilic inflammation and nasal obstruction in children with recurrent upper airway infections.

Topics: Administration, Inhalation; Anti-Inflammatory Agents; Antigens, Dermatophagoides; Budesonide; Child; Child, Preschool; Chronic Disease; Female; Humans; Immunization; Immunoglobulin E; Male; Nasal Obstruction; Neutrophils; Prevalence; Recurrence; Respiratory Tract Infections; Rhinitis, Allergic, Perennial; Time Factors

Nasal polyposis is not a life-threatening disorder but has a great impact on the quality of life. Steroids constitute the first line of treatment of nasal polyps. The aims of this study were to evaluate the quality of life in nasal polyp patients after: (1) a short course of oral steroids; and (2) a long-term treatment with intranasal steroids.. Patients with severe nasal polyps received either oral prednisone (n = 60) or no steroid treatment (control group, n = 18) for 2 weeks. Patients treated with steroids were also followed-up and evaluated after 12, 24, and 48 additional weeks with intranasal budesonide treatment.. Patients with nasal polyps showed worse scores on all SF-36 domains, except for physical functioning, compared to the Spanish general population. After two weeks, patients treated with oral prednisone demonstrated a significant improvement (p < 0.05) in all impaired QoL domains compared to both control group and baseline. The mental component summary (51.0 +/- 1.2, p < 0.05) and physical component summary (51.0 +/- 0.9, p < 0.05) were improved compared to both control group and baseline. The improvement of all SF-36 domains was sustained by intranasal budesonida (p < 0.05) after 12, 24, and 48 weeks. Nasal obstruction, sense of smell, and polyp size also improved after both the oral short course and the intranasal long-term steroids treatment (p < 0.05).. These results suggest that the treatment with a short-course of oral steroids improves the quality of life of patients with severe nasal polyps and that this effect is maintained by a long-term treatment with intranasal steroids.

Topics: Administration, Intranasal; Administration, Oral; Aged; Aged, 80 and over; Budesonide; Drug Administration Schedule; Female; Glucocorticoids; Humans; Male; Middle Aged; Nasal Obstruction; Nasal Polyps; Prednisone; Quality of Life; Smell

Topics: Anti-Inflammatory Agents; Budesonide; Combined Modality Therapy; Humans; Nasal Obstruction; Nasal Polyps; Olfaction Disorders; Prednisolone; Recovery of Function; Treatment Outcome

Evidence in vitro suggests that benzalkonium chloride, a preservative in many intranasal preparations, interferes with ciliary function and thus could potentially interfere with mucociliary transport, the mechanism for clearing secretions from the nasal cavity.. We performed a parallel randomized study with 10 subjects in each arm comparing Rhinocort AQUA (an intranasal steroid [budesonide] spray without benzalkonium chloride) and Nasonex (an intranasal steroid [mometasone furoate] spray with benzalkonium chloride). Before and after 2 weeks of treatment, subjects completed a Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and underwent a measurement of nasal clearance of a radioactive colloidal spray into the nose.. The groups were matched at entry for nasal clearance, even though there was variability among subjects. The amount of change after 2 weeks of treatment (Delta before versus after treatment) showed a significant difference in nasal clearance favoring budesonide. After 2 weeks of treatment, both budesonide and mometasone demonstrated overall improvement in quality of life as assessed by the RQLQ. Both treatments were well tolerated.. Our study extends the observation in vitro that demonstrates the adverse effect of benzalkonium chloride on cilia to a measurement in vivo of clearance. The effects after 2 weeks might not reflect changes after longer periods of treatment.. To determine the clinical significance of the small improvement in mucociliary transport will require large clinical trials.

Topics: Administration, Intranasal; Adult; Anti-Inflammatory Agents; Budesonide; Female; Humans; Male; Mometasone Furoate; Mucociliary Clearance; Nasal Obstruction; Pregnadienediols; Quality of Life; Rhinitis, Allergic, Perennial

Improving quality of life is considered to be a major endpoint and motivation for clinical intervention in patients with perennial allergic rhinitis (PAR). In addition to classical symptoms of congestion, pruritus, and rhinorrhea, patients will often complain of not being able to sleep well at night and of feeling fatigued during the day. Like sleep apnea, PAR has also been shown to cause sleep disturbance and consequently worsen daytime fatigue and somnolence.. It is proposed that by decreasing nasal obstruction due to allergic rhinitis by treating with the topical steroid budesonide, symptoms of daytime fatigue and somnolence can be improved.. Twenty-two subjects were enrolled in a double-blind, placebo-controlled, crossover study using Baalam's design. Patients were treated with either budesonide 128 g/day or placebo. Subjective data include the Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire, Rhino-conjunctivitis Quality of Life Questionnaire, and a daily diary recording nasal symptoms, sleep problems, and daytime fatigue.. The results illustrated that the topical nasal corticosteroid significantly improved daytime fatigue (P = 0.03), somnolence (P = 0.02), and quality of sleep (P = 0.05) compared to placebo in patients suffering from PAR.. Budesonide is able to improve congestion, sleep, and daytime somnolence.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Budesonide; Cross-Over Studies; Disorders of Excessive Somnolence; Double-Blind Method; Female; Glucocorticoids; Humans; Male; Middle Aged; Nasal Obstruction; Quality of Life; Rhinitis, Allergic, Perennial; Surveys and Questionnaires; Treatment Outcome

Both domiciliary and laboratory measures of nasal function have been used to evaluate treatment response in allergic airways disease; however, these measures have not been compared.. To determine the relationship of domiciliary measures (daily symptoms, peak inspiratory nasal flow, and nasal oral index) and laboratory measures (rhinomanometry, acoustic rhinometry) in assessing treatment response with topical steroids and specific inflammatory mediator blockage.. Twenty-one patients with seasonal allergic rhinitis and asthma were enrolled into a single-blind, placebo-controlled, crossover study comparing 2 weeks of 1) 400 microg inhaled plus 200 microg intranasal budesonide once daily and 2) 10 mg montelukast plus 10 mg cetirizine once daily. Before each treatment, patients received 7 to 10 days of placebo period. Laboratory measurements were made of nasal resistance by posterior rhinomanometry, and nasal volume between 0 and 5 cm by acoustic rhinometry after both placebo and active treatment periods. Daily domiciliary recordings were made of allergic rhinitis nasal symptoms scores and peak nasal and oral inspiratory flow rate (enabling the calculation of a nasal/oral index) throughout the study.. There were significant (P < 0.05) improvements for all allergic rhinitis symptoms with both therapies, after factoring for pollen count. Spearman's rank correlation for comparison among nasal symptoms and the objective responses were: nasal inspiratory flow rate (R = -0.50, P = 0.02); nasal/oral index (R = -0.55 P = 0.01); rhinomanometry (R = 0.24, P = 0.30); and acoustic rhinometry (R = -0.21, P = 0.36).. Both treatments were effective in managing allergic rhinitis symptoms, and patients' symptoms were more closely associated with domiciliary measurements of nasal flow than laboratory measurements of nasal function.

Topics: Acetates; Administration, Inhalation; Administration, Intranasal; Adult; Airway Resistance; Anti-Allergic Agents; Anti-Inflammatory Agents; Asthma; Budesonide; Cetirizine; Cross-Over Studies; Cyclopropanes; Female; Glucocorticoids; Histamine H1 Antagonists; Humans; Leukotriene Antagonists; Male; Nasal Obstruction; Quinolines; Rhinitis, Allergic, Seasonal; Rhinomanometry; Rhinometry, Acoustic; Sulfides

Allergic rhinitis is usually treated with oral antihistamines or nasal steroids. Topically active nasal antihistamine is a new treatment modality for allergic rhinitis. The efficacy in comparison to well established topical treatment alternatives is not fully known.. To compare the efficacy of intranasally administered azelastine to budesonide, at their respectively recommended dosage, on the symptoms of perennial rhinitis patients.. A placebo-controlled, randomized, parallel group study was conducted to compare the efficacy and tolerability of intranasal budesonide aqueous suspension (256 microg once daily) with azelastine hydrochloride nasal spray (280 microg twice daily (560 microg/day)) and with placebo in the treatment of perennial allergic rhinitis. The 195 patients (with at least a 2-year history of perennial allergic rhinitis) recorded individual nasal symptom scores, the degree of symptom control achieved and any adverse events experienced over a 2-week baseline period and a 6-week treatment period.. Following treatment, the reductions in mean combined and individual nasal symptom scores from baseline values were significantly greater in the budesonide group compared with the placebo group (P < .0001 for all variables except runny nose P = .01). In patients treated with budesonide, there were also significantly larger reductions from baseline values in combined nasal symptom scores (P < .01) and in scores for all individual nasal symptoms (P < or = .05) compared with those treated with azelastine. The reductions from baseline in both combined and individual nasal symptom scores did not differ between azelastine and placebo. The study medications were well tolerated, producing no unexpected or serious treatment-related adverse events.. A once-daily dose of 256 microg of intranasal budesonide aqueous suspension is significantly more effective at relieving the symptoms of perennial allergic rhinitis compared with a twice daily dose of 280 microg of azelastine nasal spray.

Topics: Administration, Inhalation; Adolescent; Adult; Aged; Budesonide; Double-Blind Method; Drug Tolerance; Female; Humans; Male; Middle Aged; Nasal Obstruction; Phthalazines; Rhinitis, Allergic, Perennial

The study investigated the effect of the oral H1-blocker terfenadine on allergen challenge in subjects with nasal allergy in comparison with the topical steroid, budesonide. A randomized, placebo-controlled, double-blind, crossover study with 3 experimental days was performed outside the pollen season. Seventeen nonsmokers with hay fever (symptoms, positive skin prick test, and RAST against timothy) were treated for 14 days before each experimental day, where the response to nasal challenge with four different concentrations of timothy was measured every 15 min for 6 h. The nasal cavity dimensions were measured by acoustic rhinometry and the olfactory function as the threshold for the sense of smell of butanol. Nasal symptoms were determined by questionnaires. Both terfenadine and budesonide dry powder had an effect on the hay fever symptoms during nasal pollen challenge. Terfenadine was more efficient than budesonide against histamine-mediated symptoms such as sneezing and itching. Budesonide increased nasal airway dimensions better than terfenadine (P < 0.01). A marked effect of budesonide was seen 1-2 h after challenge, suggesting an effect on "early late phase" reaction in the nose. In 7/17 subjects, a significant (P < 0.05) improvement of olfactory function after budesonide treatment was seen. In conclusion, topical steroid (budesonide) is superior to antihistamine (terfenadine) in treatment of nasal congestion in hay fever, especially for the postchallenge reaction, and may, in some cases, relieve the decreased sense of smell during pollen challenge.

Topics: Administration, Inhalation; Administration, Topical; Adult; Allergens; Anti-Inflammatory Agents; Bronchodilator Agents; Budesonide; Cross-Over Studies; Double-Blind Method; Female; Glucocorticoids; Histamine H1 Antagonists; Humans; Male; Nasal Mucosa; Nasal Obstruction; Nasal Provocation Tests; Powders; Pregnenediones; Rhinitis, Allergic, Seasonal; Smell; Terfenadine

Intranasal budesonide and beclomethasone dipropionate (BDP), each administered as aqueous, aerosol formulations at dosages of 200 micrograms twice a day, morning and evening, were compared over a 3-week period in a randomized, parallel group study of 88 adults with seasonal allergic rhinitis. Budesonide treatment produced significantly lower mean symptom scores for the whole study compared with BDP for runny nose, itchy nose and sneezing (P < 0.05). The difference in nasal symptom scores produced by budesonide in comparison with BDP was particularly great towards the end of the treatment period. The budesonide-treated group also had lower scores for nasal blockage and two eye symptoms (runny and sore eyes), but the differences noted were not significant. Adverse events recorded by both groups were mild and transient. In conclusion, aqueously administered budesonide is likely to be of more clinical value than BDP for the control of seasonal allergic rhinitis.

Topics: Administration, Intranasal; Adolescent; Adult; Aerosols; Anti-Inflammatory Agents; Beclomethasone; Budesonide; Endophthalmitis; Female; Glucocorticoids; Humans; Male; Medical Records; Middle Aged; Nasal Obstruction; Pregnenediones; Pruritus; Rhinitis; Rhinitis, Allergic, Seasonal; Single-Blind Method; Sneezing

Budesonide improves the prognosis of chronic rhinosinusitis (CRS). However, few reports have examined whether its use for nasal irrigation, compared to normal saline, improves the prognosis of patients after endoscopic sinus surgery (ESS). We compared the effects of nasal irrigation with budesonide and normal saline in CRS patients after ESS.. Sixty CRS patients who had undergone ESS were randomly divided into an experimental group (30 patients), which used budesonide nasal irrigation, and a control group (30 patients), which used normal saline nasal irrigation. All patients received regular follow-up evaluations and were assessed via questionnaires, including the Lund-Kennedy endoscopic score (LKES), the symptom visual analog scale (VAS), the 22-item Sino-Nasal Outcome Test (SNOT-22), the Short-Form 36-Item Questionnaire (SF-36), the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS) and a side effects scale.. Scores of polyposis, mucosal edema, secretions and total score of LKES; VAS scores of nasal blockage, hyposmia and rhinorrhea; and SNOT-22 results in both groups were significantly improved 3 months after ESS. Scores of polyposis, mucosal edema, secretions and scarring and total score of LKES in experimental group were significantly better than in control group 3 months after ESS. No significant differences were observed in SF-36, SAS or SDS before or 3 months after ESS within or between the two groups. The side effects of the two groups were not significantly different.. Nasal irrigation improved the prognosis of CRS patients after ESS. Budesonide nasal irrigation had a better effect than normal saline nasal irrigation.

Topics: Adult; Anti-Inflammatory Agents; Budesonide; Chronic Disease; Endoscopy; Female; Humans; Male; Middle Aged; Nasal Lavage; Nasal Obstruction; Paranasal Sinuses; Postoperative Complications; Prognosis; Rhinitis; Sinusitis; Treatment Outcome

Previous rhinomanometry studies have shown significant long-term variability of the nasal airway resistance and questioned the clinical validity of rhinomanometry.. Could treatment with a topical glucocorticoid, budesonide, influence the long-term variability of active anterior rhinomanometry?. Eight healthy volunteers participated in an unblinded controlled trial without, and later with, nasal budesonide once a day for 5 months. Their nasal airway resistance was measured every two weeks with active anterior rhinomanometry before and after decongestion with xylometazoline hydrochloride. In addition, subjective nasal obstruction was evaluated on a Visual Analogue Scale before each measurement. The participants had a year earlier been investigated with rhinomanometry every two weeks during 5 months but without budesonide treatment. We compared the variability of nasal airway resistance during the two periods with and without treatment with topical budesonide.. Budesonide significantly reduced mean nasal airway resistance and the standard deviation of the mean after decongestion for 6 of 8 participants. The mean reduction of the nasal airway resistance was 40% for the decongested nasal cavity compared to the period without treatment with nasal budesonide. Subjective nasal obstruction assessed by Visual Analogue Scale was reduced in 3 of the 8 participants.. The variability of nasal airway resistance was significantly reduced by treatment with topical budesonide for 6 out of 8 healthy volunteers participating in an unblinded repeated 5 month trial where the participants served as their own controls.

Topics: Airway Resistance; Budesonide; Glucocorticoids; Humans; Imidazoles; Nasal Cavity; Nasal Obstruction; Rhinomanometry

Nocturnal enuresis has been associated with obstructive sleep apnea-hypopnea and may resolve after adenotonsillectomy. Nasal corticosteroids have improved symptoms and polysomnography findings in children with snoring. Two children with primary nocturnal enuresis, chronic nasal obstruction, and loud snoring underwent polysomnography. The apnea-hypopnea index was 4.9 and 7.3 episodes/hr, and the oxygen desaturation of hemoglobin index was 4.6 and 5.2 episodes/hr. After administration of budesonide, the frequency of snoring decreased, the polysomnography findings improved, and the enuresis resolved completely. Six months after treatment, both children were still dry at night. Administration of nasal corticosteroids is associated with resolution of enuresis in children with mild obstructive sleep-disordered breathing.

Topics: Administration, Intranasal; Budesonide; Child; Enuresis; Female; Humans; Male; Nasal Obstruction; Remission Induction; Snoring