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400

International consensus statement on rhinosinusitis

90% improvement on PGIC, significant

reduction in SNOT 22, improved

endoscopy scores.

6% with elevated IOP, 3% with adrenal insufficiency.

in both SNOT-16 and endoscopy scores, continuing at 16

week follow-up.

3 month course of twice daily budesonide irrigations (500 μ g into > 100 mL saline) Endoscopy score Budesonide irrigations may improve endoscopy scores.

symptom score and

SNOT-22 scores in

CRSsNP. High tissue eosinophilia predicted better response.

improved SNOT-20

scores, and did not affect adrenal function.

Improved SNOT-22, endoscopy scores, anterior and

posterior rhinorrhea, good safety profile.

Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Steinke 1081 2009 (n = 8)

Significant reduction

Improvement in

Topical budesonide

Lund-Kennedy endoscopy score

Endoscopy score SNOT-22 PGIC

ACTH suppression test Intraocular pressure Symptom score SNOT-22

Need for oral corticosteroids HRQoL (SNOT-16) Endoscopy scores

Need for revision surgery

SNOT-20

Adrenal function

SNOT-22

Endoscopy score PGIC

Sachanandani 1080 2009 (n = 9) 4 Prospective case-series 30 days course of 250 μ g

Patients treated with MAD and budesonide x > 6 months

Tobramycin (10 mL of 0.8 mg/mL) and CiproxinHC R (0.4mL

exhalational device with 372 μ g fluticasone BID x 12weeks

Palmer 1085 2018 (n = 189) 4 Prospective case-series 12 month use of EDS-FLU 372 μ g fluticasone BID

of ciprofloxacin 2 mg/mLand

hydrocortisone 10 mg/mL)

Moshaver 1088 2010 (n = 13) 4 Prospective case series Bilateral MAST catheter insertion with 3 weeks’ daily irrigation of

Snidvongs 1079 2012 (n = 111) 4 Prospective case-series Once daily irrigations of 1 mg budesonide/

betamethasone in 240 mL saline

budesonide diluted into 5 mL of isotonic saline each nostril QID

Sher 1084 2020 (n = 603) 4 Prospective, case series Twice daily EDS-FLU

observational study

3 Prospective, pilot, cohort study

Manji 1087 2017 (n = 100) 4 Cross sectional

TABLE IX-27 (Continued)