Inhaled glucocorticosteroids in otorhinolaryngology

• Main Authors: T. I. Garashchenko, G. D. Tarasova
• Format: Article
• Language: Russian
• Published: Remedium Group LLC 2020-03-01
• Series: Медицинский совет
• Subjects: inhaled glucocorticosteroids; fluticasone propionate; rhinosinusitis; allergic rhinitis; adenoiditis
• Online Access: https://www.med-sovet.pro/jour/article/view/5538

Currently, there is a wide introduction of inhaled  glucocorticosteroids (InGCS) into otorhinolaryngological practice, which is explained by their local impact and low bioavailability, as well as proven high therapeutic effectiveness in various forms of rhinosinusitis (RS), adenoiditis and allergic rhinitis (AR). The feasibility of using InGCS enshrined in international consensus documents. Thus, this group of drugs is recommended  for use in acute postviral and bacterial  MS, chronic MS, polypous chronic rhinosinusitis, and in the postoperative period when intervening in the nasal cavity and in the paranasal sinuses.Recently, due to the deterioration of the environmental situation in the world and in connection with the improvement of the diagnosis of sensitization, the number of patients suffering from AR has increased. InGCS are included in the complex of treatment of moderate and severe course of intermittent and persistent AR.The effectiveness of InGCS in non-allergic eosinophilic rhinitis has been proved. In the complex therapy of adenoids and chronic adenoiditis, InGCS is also used with a high degree of efficiency, which allows such patients to avoid invasive treatment methods, including adenotomy.Particularly severe course of RS and adenoids is observed in patients with allergies. In this situation, the feasibility of using InGCS has been proven.One of the most effective and safe drugs in this group is fluticasone propionate (FP) - Flixonase, especially if the patient is sensitized to inhaled allergens. The advantages and possible side effects of FP are described.The authors cite the results of their own research, which used FP in the complex treatment of children with nasal breathing difficulties caused by adenoids and various forms of AR. As a result of 3 months of treatment and follow-up, 95.2% of patients recovered nasal breathing and no need for surgical removal of adenoids.The authors consider the feasibility and effectiveness of using inhaled glucocorticosteroids in the treatment of major diseases of the ENT organs, such as various forms of rhinosinusitis (RS), allergic and non-allergic rhinitis, and adenoiditis. It is emphasized that this group of drugs has an evidence base and is included in the main concession documents on otorhinolaryngology. Their advantages, pharmacotherapy and possible side effects are noted. The advantages of the drug fluticasone propionate (Flixonase), the relevance and advantages of its use are highlighted. The paper presents the authors own observations in the treatment of patients with nasal polypous chronic RS with this drug.