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Efficacy and safety of delivery of topical medication on to the frontal sinus at different head positions after frontal sinusotomy

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

A Correction to this article was published on 06 March 2020

This article has been updated

Abstract

Purpose

Effective topical medications delivery to the frontal sinus is crucial to recovery from frontal sinusotomy. However, finding a way to deliver local medications to the frontal sinus is still a major challenge. The objective of this study was to evaluate the influence of various head positions on postoperative frontal sinus drug deposition. The safety and efficacy were also evaluated in postoperative chronic rhinosinusitis (CRS) patients.

Methods

Full house surgery was performed on six fresh frozen cadaver heads. The fluorescein solution was dropped into the nasal sinuses in three different head positions, and the fluorescein deposition was evaluated. A prospective cohort study was performed to validate the results in 20 postoperative CRS patients. The cortisol level, symptom VAS and the frontal recess endoscopy scores were evaluated pre- and postoperatively.

Results

The frontal recess delivery of fluorescein was better in the Mygind and vertex-to-floor positions than in the head back position. The cortisol level of patients dropped markedly after taking oral methylprednisolone, but returned to baseline when replaced with budesonide drops. The pre- and postoperative symptom VAS scores did not differ significantly between the two groups. Endoscopic scores of the vertex-to-floor group were significantly better than those of the Mygind group.

Conclusion

Both the Mygind and the vertex-to-floor head positions were optimal for delivery of topical medications to the frontal recess. When applying the steroid drops, both positions were found to be safe and associated with effective relief of symptoms. The vertex-to-floor position can better improve the endoscopic scores of frontal recess and frontal sinus.

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Change history

  • 06 March 2020

    In the original publication of the article, under the experimental protocol of the section “Clinical head position study in postoperative CRS patients”, the following sentence “There were 20 CRS patients, 12 male and 8 female across an age range of 19–64 years…” was published incorrectly.

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Funding

Capital Health Development Foundation (no: 2016-1-2052) and the Research and Development Foundation of the Peking University People’ Hospital (RDB-2015-03) supported this study.

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Author notes

  1. Yu-Xiao Wu and Hui Li contribute equally to this paper.

Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Peking University People’s Hospital, Xi Zhi Men Nan Da Jie 11#, Beijing, 100044, People’s Republic of China

    Yu-Xiao Wu, Min Wang, Hui Li, Zhi-Min Xing, Mu-Han Shi, Shi-En Huang, Yan Liu & Cong-Li Geng

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  1. Yu-Xiao Wu
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  2. Min Wang
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Correspondence to Min Wang.

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None of the above-mentioned authors has a conflict of interest regarding this publication.

Ethical approval

This study was reviewed and approved by the Institutional Ethical Committee of Peking University People’s Hospital, and was conducted in compliance with the Helsinki Declaration.

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Informed consent was obtained for all patients who participated in the research.

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Wu, YX., Wang, M., Li, H. et al. Efficacy and safety of delivery of topical medication on to the frontal sinus at different head positions after frontal sinusotomy. Eur Arch Otorhinolaryngol 277, 1361–1368 (2020). https://doi.org/10.1007/s00405-020-05851-w

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  • DOI: https://doi.org/10.1007/s00405-020-05851-w

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