ST. LOUIS, Mo. (Ivanhoe Newswire) — According to the CDC, more than 30 million adults in the U.S. struggle with chronic sinusitis: stuffy nose, congestion, swelling, facial pain, trouble sleeping – the symptoms can be debilitating. Now, a new way of treating it may finally offer relief.

Jim Dryden is pretty healthy, but when he comes down with even a mild virus, watch out.

Dryden said, “When I get a cold, for instance, it would last for probably five or six weeks.”

Simple colds lead to flare-ups of sinusitis. Desperate for relief, Dryden enrolled in a study with Jay Piccirillo, MD, an otolaryngologist at Washington University St. Louis.

Dr. Piccirillo said, “Oftentimes, they’re prescribed multiple rounds of antibiotics, which have their own costs and side effects.”

Dr. Piccirillo is testing a way to deliver the steroid budesonide deep into the nasal cavity using nasal lavage, a method you might know as a neti pot. Budesonide is a common anti-inflammatory nasal spray. Dryden mixes the steroid in his nasal rinse every day.

“The lavage actually delivers the medicine to areas of the nose that we don’t think the medicine can get to by just using the spray,” said Dr. Piccirillo.

His study shows an extra 20 percent reduction in symptoms.

Dr. Piccirillo stated, “We think the addition of the steroid medicine to the lavage is an alternative to antibiotics and, in fact, it’s probably even more effective because at the end, probably most of chronic rhinosinusitis is an inflammation problem, not an infection problem.”

“It has been very helpful,” Dryden told Ivanhoe.

Dr. Piccirillo says both budesonide and the use of nasal lavage are common and widely available. The new part is simply the delivery system. Dr.

Piccirillo says this is available right now to patients who are interested. He suggests patients talk to their doctor about how to add the powder form of the drug, not the commonly used spray, to a saltwater nasal rinse.

Contributors to this news report include: Stacie Overton Johnson, Field Producer; Rusty Reed, Videographer; Cyndy McGrath, Supervising Producer; Jamison Kozcan, Editor.

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REPORT: MB #4656

BACKGROUND: Chronic sinusitis is a long-lasting sinus infection. The sinuses are four paired cavities in the head. These spaces are connected by narrow channels. The sinuses make thin mucus that drains out of the channels of the nose. This drainage works as a filtration system, keeping the nose clean and free of bacteria. The sinuses can become infected when they are blocked and filled with fluid. This is called sinusitis. There are two types of sinusitis: acute and chronic. Acute sinusitis lasts only a few days before going away with minimal treatment. Chronic sinusitis can linger over a long period of time. Surgery is sometimes needed in severe cases of chronic sinusitis.

TREATMENT: Treatments for chronic sinusitis may include nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone, triamcinolone, budesonide, mometasone and beclomethasone. If the sprays aren’t effective enough, your doctor might recommend rinsing with a solution of saline mixed with drops of budesonide or using a nasal mist of the solution. Another option is saline nasal irrigation, with nasal sprays or solutions which reduces drainage and rinses away irritants and allergies. You may also try oral or injected corticosteroids. These medications are used to relieve inflammation from severe sinusitis, especially if you also have nasal polyps. Oral corticosteroids can cause serious side effects when used long term, so they’re used only to treat severe symptoms.

NEW COMBINATION: Jay Piccirillo, MD, an Otolaryngologist from Washington University, St. Louis talked about the results he found, “Our study showed that 20 percent more patients in the budesonide group experienced a clinically meaningful improvement in symptoms as compared to the placebo group. The 20 percent comes from the following, “Of the 29 participants who received budesonide, 23 (79 percent) experienced a clinically meaningful reduction in their SNOT-22 (Sino-nasal Outcome Test) scores as compared with the 32 participants in the placebo of whom 19 (59 percent) experienced a clinically meaningful improvement.” Dr. Piccirillo says the combined saline rinse with budesonide is available right now to patients who are interested. He suggests patients talk to their doctor about obtaining budesonide in a powder or liquid form to add to a saltwater nasal rinse.
(Source: Jay Piccirillo, MD)


Judy Martin Finch

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