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Contemporary Use of Corticosteroids in Rhinology

  • Rhinosinusitis (J Mullol, Section Editor)
  • Published:
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Abstract

Purpose of Review

Exogenously administered corticosteroids are widely used today in the field of rhinology. Allergic rhinitis (AR), non-allergic rhinitis (NAR), acute rhinosinusitis (ARS), chronic rhinosinusitis with (CRSwNP) and without (CRSsNP) nasal polyps, and autoimmune disorders with nasal manifestations are common diseases treated effectively with intranasal and oral glucocorticoids. We focus on physiological pathways, therapeutic benefits, indications, contra-indications, and side effects of glucocorticoid utilization in the treatment of rhinologic disorders such as AR, NAR, ARS, CRSsNP, and CRSwNP.

Recent Findings

Second-generation intranasal steroid (INS) agents have pharmacokinetic characteristics that minimize their systemic bioavailability, resulting in minimum risk for systemic adverse events. Several studies have demonstrated the symptomatic efficacy of both intranasal and oral corticosteroids in ARS. Moreover, intranasal and systemic steroid administration has been repeatedly proven beneficial in the conservative and perioperative management of CRSwNP. For patients with AR, there is no need for oral steroids, with the exception of severe cases, as there is lack of superiority to INS. SCUAD patients challenge currently available treatment schemes, underlining the importance of research in the field.

Summary

Corticosteroids’ effectiveness in the treatment of various rhinologic disorders is indisputable. However, their characteristics, and potential side effects, make a clear consensus for utilization difficult.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, School of Medicine, University of Crete, Heraklion, Crete, Greece

    Alexander Karatzanis, Alkiviadis Chatzidakis, Athanasia Milioni, Stylianos Velegrakis & Emmanuel Prokopakis

  2. Department of Otorhinolaryngology, St. Jan General Hospital, Bruges, Belgium

    Stephan Vlaminck

  3. Department of Otorhinolaryngology, School of Medicine, University of Shimane, Shimane, Japan

    Hideyuki Kawauchi

  4. Department of Otorhinolaryngology, University Hospital of Crete, University avenue, A Building 3rd Floor, 71110, Heraklion, Crete, Greece

    Emmanuel Prokopakis

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  1. Alexander Karatzanis
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Karatzanis, A., Chatzidakis, A., Milioni, A. et al. Contemporary Use of Corticosteroids in Rhinology. Curr Allergy Asthma Rep 17, 11 (2017). https://doi.org/10.1007/s11882-017-0679-0

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