Clinical Effectiveness of Local Application of Beclomethasone Dipropionate Dry Powder for the Treatment of Chronic Rhinosinusitis with Eosinophil Infiltration

  • Takeno Sachio
    Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • Takeda Kazumasa
    Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • Nishi Yasuyuki
    Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • Ishino Takashi
    Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • Hirakawa Katsuhiro
    Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University

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  • 好酸球性副鼻腔炎に対する周術期の局所ステロイド噴霧療法の臨床効果

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Chronic rhinosinusitis (CRS) with eosinophil infiltration is characterized by unrestrained proliferation of eosinophils that form clusters in the mucus where they release toxic granules. The mechanisms by which eosinophilic inflammation damages the epithelium and contributes to recurrent acute exacerbations in the disease have not been fully elucidated. Local or systematic administration of glucocorticoids is considered to be potent treatment strategy to prevent relapse of nasal poyposis.<br>In the present study, we assessed whether topical instillation of beclomethasone dipropionate dry powder onto the paranasal sinus improved the post-operative nasal symptoms and radiological sinus scores in patients with CRS after appropriate surgical intervention. Eighteen CRS patients with eosinophil infiltration who underwent endoscopic sinus surgery were recruited. The patients were treated with 800μg beclomethasone every two weeks using an application device at least for 2 months. We found an improvement in the endoscopic appearance scores in 91.4% of patients who received beclomethasone. The result was better than that obtained from the previous study treated with conventional postoperative therapy (71.7%). Significant decreases in the averaged CT scores for the paranasal sinuses were noted from 5.62 to 1.93 after treatment.<br>We consider that topical use of beclomethasone dry powder is effective for the post-surgical treatment of CRS with eosinophil infiltration through the control of the inflammatory process that persists in the nasal cavity.

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