Chinese expert recommendation on transnasal corticosteroid nebulization for the treatment of chronic rhinosinusitis 2021

Chengshuo Wang; Lei Cheng; Huabin Li; Zheng Liu; Hongfei Lou; Jianbo Shi; Ying Sun; Dehui Wang; Qintai Yang; Hongmeng Yu; Changqing Zhao; Dongdong Zhu; Fengli Cheng; Yan Li; Bo Liao; Meiping Lu; Cuida Meng; Shen Shen; Yueqi Sun; Rui Zheng; Luo Zhang

doi:10.21037/jtd-21-1142

Chinese expert recommendation on transnasal corticosteroid nebulization for the treatment of chronic rhinosinusitis 2021

J Thorac Dis. 2021 Nov;13(11):6217-6229. doi: 10.21037/jtd-21-1142.

Authors

Chengshuo Wang^#^{1

2

3}, Lei Cheng^#^{4

5}, Huabin Li^#⁶, Zheng Liu^#⁷, Hongfei Lou^#^{1

2

3}, Jianbo Shi^#⁸, Ying Sun^#^{1

2

9}, Dehui Wang^#⁶, Qintai Yang^#¹⁰, Hongmeng Yu^#^{6

11}, Changqing Zhao^#¹², Dongdong Zhu^#¹³, Fengli Cheng¹², Yan Li^{1

2

3}, Bo Liao⁷, Meiping Lu⁴, Cuida Meng¹³, Shen Shen^{1

2

3}, Yueqi Sun¹⁴, Rui Zheng¹⁰, Luo Zhang^{1

2

3

15}

Affiliations

¹ Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
² Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
³ Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China.
⁴ Department of Otorhinolaryngology & Clinical Allergy Center, the First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
⁵ International Centre for Allergy Research, Nanjing Medical University, Nanjing, China.
⁶ Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China.
⁷ Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁸ Otorhinolaryngology Hospital, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁹ Department of Immunology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.
¹⁰ Department of Otorhinolaryngology-Head and Neck Surgery, Department of Allergy, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
¹¹ Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor, Chinese Academy of Medical Sciences, Shanghai, China.
¹² Department of Otorhinolaryngology-Head and Neck Surgery, Second Hospital of Shanxi Medical University, Taiyuan, China.
¹³ Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
¹⁴ Department of Otolaryngology, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
¹⁵ Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

^# Contributed equally.

Abstract

Corticosteroids are efficacious in treating chronic rhinosinusitis (CRS), but concerns on the potential side effects remain, especially for long-term usage of systemic corticosteroids. Accumulated evidence shows that transnasal nebulization may be a reasonable solution in balancing both efficacy and safety. However, no consensus or guideline has been formulated on the use of steroid transnasal nebulization in treating CRS. The consensus is achieved through literature review and exchange of Chinese experts in Group of Otorhinolaryngology and Ophthalmology, Chinese Society of Allergy (CSA). This document covers the development, equipment, pharmacological mechanism, and evidence-based efficacy and safety, as well as the special concern of the application of steroid transnasal nebulization during the coronavirus disease (COVID-19) pandemic. The expert consensus clarifies the application of steroid transnasal nebulization in treating CRS and common comorbidities during the perioperative and postoperative periods.

Keywords: Chronic rhinosinusitis (CRS); corticosteroids; efficacy; safety; transnasal nebulization.

Publication types

Review