Nasal steroid may treat acute sinusitis

Scientists at the Medical Center have found that intranasal steroids may enhance the effectiveness of nasal sprays used to treat patients with acute sinusitis.

"This research verifies that intranasal steroids can speed the resolution of sinus symptoms in patients with acute sinusitis, which is especially important for most working adults who will do just about anything to recover in order to get back to normal life," said co-principal investigator Dr. David Witsell, an assistant professor in the division of otolaryngology in the department of surgery. "Most physicians had the impression that [steroidal supplements] might help, but it's never been shown before."

The researchers based their findings, published last month in the Journal of the American Medical Association, on self-reports from test subjects about any substantial improvement of sinusitis symptoms over a three-week period during which patients took the steroid fluticasone propinate. A higher proportion of patients using the steroid reported being cured and having faster symptom relief than those taking the placebo.

Intranasal steroids prevent migration of white blood cells and formation of swelling within drainage tracts, decreasing inflammation in the nose. This promotes drainage and healing of the sinus so antibiotics can work more effectively.

Steroids may also speed the elimination of infectious organisms and decrease the frequency and severity of recurrent sinus infections.

Co-principal investigator Dr. Rowena Dolor, an associate in the division of general medicine, said she believes these findings will lead to changes in treatment options for patients with acute sinusitis.

"The research results are compelling enough to recommend that clinicians include intranasal steroids as part of the therapeutic regimen for the treatment of acute sinusitis in patients with a history of recurrent or chronic sinus symptoms," she said. "The impact of our recommendation should shorten symptom duration and increase improvement rates for patients suffering from a sinus infection."

Patients were diagnosed with sinusitis based on clinical symptoms and confirmed by sinus radiography or endoscopy, but the researchers did not collect samples to find out which infections were bacterial and which were viral because the study was primarily clinically-based.