무후각증 환자에서 흡수성 비강 충전물을 이용한 직접적인 Triamcinolone 적용의단기 효능과 안정성
Short-Term Efficacy and Safety of the Direct Triamcinolone Application Using Absorbable Nasal Packing in Anosmic Patients
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives The most common treatment for olfactory dysfunction is theuse of glucocorticoids. However, using systemic glucocorticoids is limited due to systemicside effects, and topical glucocorticoids are less effective than systemic glucocorticoids. Theaim of this study is to evaluate short-term therapeutic effects of direct triamcinolone (TA) ap-plication using absorbable nasal packing material on anosmia patients. Subjects and Method This was a retrospective study that evaluated patients who were di-agnosed with anosmia and treated with oral prednisolone (PD) pulse therapy or 2 times of a 20mg dose of TA impregnated absorbable nasal packing in both olfactory clefts. Information of thedemographic features, the self-reporting olfaction scores (visual analogue scale [VAS], 0-10),and the threshold, discrimination, identification (TDI) scores of Korean version of the Sniffin’stick test II were collected and analyzed. Results The data of 72 patients were analyzed in this study: 30 patients were treated withTA nasal packing, and 42 patients with oral PD. In both group, VAS and TDI scores were sig-nificantly improved 2 weeks after treatment. The rate of significant olfactory improvement ofTA nasal packing group was higher than oral PD group (60.0% vs. 47.6%), but there was nostatistically significant difference ( p=0.300). There was no significant systemic adverse effectafter TA nasal packing treatments. Conclusion Direct TA application using absorbable nasal packing is a possible treatment op-tion in anosmic patients.
Abstract
Background and Objectives The most common treatment for olfactory dysfunction is theuse of glucocorticoids. However, using systemic glucocorticoids is limited due to systemicside effects, and topical glucocorticoids are less effective than systemic glucocorticoids. Theaim of this study is to evaluate short-term therapeutic effects of direct triamcinolone (TA) ap-plication using absorbable nasal packing material on anosmia patients. Subjects and Method This was a retrospective study that evaluated patients who were di-agnosed with anosmia and treated with oral prednisolone (PD) pulse therapy or 2 times of a 20mg dose of TA impregnated absorbable nasal packing in both olfactory clefts. Information of thedemographic features, the self-reporting olfaction scores (visual analogue scale [VAS], 0-10),and the threshold, discrimination, identification (TDI) scores of Korean version of the Sniffin’stick test II were collected and analyzed. Results The data of 72 patients were analyzed in this study: 30 patients were treated withTA nasal packing, and 42 patients with oral PD. In both group, VAS and TDI scores were sig-nificantly improved 2 weeks after treatment. The rate of significant olfactory improvement ofTA nasal packing group was higher than oral PD group (60.0% vs. 47.6%), but there was nostatistically significant difference ( p=0.300). There was no significant systemic adverse effectafter TA nasal packing treatments. Conclusion Direct TA application using absorbable nasal packing is a possible treatment op-tion in anosmic patients.
참고문헌 (27)
- Stevenson RJ, "An initial evaluation of the functions of human olfaction", Chem Senses, 35(1), pp.3~20 (2010)
- Landis BN, "A study on the frequency of olfactory dysfunction", Laryngoscope, 114(10), pp.1764~1769 (2004)
- Doty RL, "Smell identification ability : Changes with age", Science, 226(4681), pp.1441~1443 (1984)
- Deems DA, "Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center", Arch Otolaryngol Head Neck Surg, 117(5), pp.519~528 (1991)
- Hummel T, "Olfactory disorders and their consequences for quality of life", Acta Otolaryngol, 125(2), pp.116~121 (2005)
- Hummel T, "Position paper on olfactory dysfunction", Rhinol Suppl, 54(26), pp.1~30 (2017)
- Stenner M, "Topical therapy in anosmia : Relevance of steroid-responsiveness", Laryngoscope, 118(9), pp.1681~1686 (2008)
- Scheibe M, "Intranasal administration of drugs", Arch Otolaryngol Head Neck Surg, 134(6), pp.643~646 (2008)
- Hong SD, "Systemic effects and safety of triamcinolone-impregnated nasal packing after endoscopic sinus surgery: A randomized, doubleblinded, placebo-controlled study", Am J Rhinol Allergy, 27(5), pp.407~410 (2013)
- Gudziol V, "Clinical significance of results from olfactory testing", Laryngoscope, 116(10), pp.1858~1863 (2006)
- Hüttenbrink KB, "Olfactory dysfunction : Common in later life and early warning of neurodegenerative disease", Dtsch Arztebl Int, 110(1-2), pp.1~7 (2013)
- Hummel T, "Effects of olfactory training in patients with olfactory loss", Laryngoscope, 119(3), pp.496~499 (2009)
- Seiden AM, "The diagnosis of a conductive olfactory loss", Laryngoscope, 111(1), pp.9~14 (2001)
- Robinson AM, "Expression of glucocorticoid receptor mRNA and protein in the olfactory mucosa : Physiologic and pathophysiologic implications", Laryngoscope, 108(8 Pt 1), pp.1238~1242 (1998)
- Fong KJ, "Olfactory secretion and sodium, potassium-adenosine triphosphatase:Regulation by corticosteroids", Laryngoscope, 109(3), pp.383~388 (1999)
- Blomqvist EH, "Placebocontrolled, randomized, double-blind study evaluating the efficacy of fluticasone propionate nasal spray for the treatment of patients with hyposmia", anosmia, 2003, pp.123(7), 862~868
- Shu CH, "Topical corticosteroids applied with a squirt system are more effective than a nasal spray for steroid-dependent olfactory impairment", Laryngoscope, 122(4), pp.747~750 (2012)
- Mott AE, "Disorders in taste and smell", Med Clin North Am, 75(6), pp.1321~1353 (1991)
- Mori E, "The administration of nasal drops in the"Kaiteki"position allows for delivery of the drug to the olfactory cleft : A pilot study in healthy subjects", Eur Arch Otorhinolaryngol, 273(4), pp.939~943 (2016)
- Reychler G, "Effect of three-drug delivery modalities on olfactory function in chronic sinusitis", Laryngoscope, 125(3), pp.549~555 (2015)
- Lam K, "Comparison of nasal sprays and irrigations in the delivery of topical agents to the olfactory mucosa", Laryngoscope, 123(12), pp.2950~2957 (2013)
- Xu J, "Effects of triamcinolone-impregnated nasal dressing on subjective and objective outcomes following endoscopic sinus surgery", Eur Arch Otorhinolaryngol, 273(12), pp.4351~4357 (2016)
- Murr AH, "Safety and efficacy of a novel bioabsorbable, steroid-eluting sinus stent", Int Forum Allergy Rhinol, 1(1), pp.23~32 (2011)
- Bardaranfar MH, "The effect of an absorbable gelatin dressing impregnated with triamcinolone within the olfactory cleft on polypoid rhinosinusitis smell disorders", Am J Rhinol Allergy, 28(2), pp.172~175 (2014)
- Benninger MS, "The safety of intranasal steroids", Otolaryngol Head Neck Surg, 129(6), pp.739~750 (2003)
- Pieringer H, "Patients with rheumatoid arthritis undergoing surgery : How should we deal with antirheumatic treatment?", Semin Arthritis Rheum, 36(5), pp.278~286 (2007)
- Ikeda K, "Subclassification of chronic rhinosinusitis with nasal polyp based on eosinophil and neutrophil", Laryngoscope, 123(11), pp.E1~9 (2013)