Injection of Steroid in Nasal Polyps: A Systematic Review.

BACKGROUND: Chronic rhinosinusitis (CRS) is a common chronic condition classically divided into two phenotypes according to the presence or absence of nasal polyps. The effects of both medical and surgical treatment are often temporary, encouraging research into new treatment options. METHODS: We performed a systematic review related to dosages, effects, side effects, and safety of intrapolyp steroid injection in patients with nasal polyps. We identified five studies with a total of 386 patients and 2490 intrapolyp steroid injections. RESULTS: Treatment with intrapolyp steroid injection leads to a decrease in the Total Nasal Polyps Score (TNPS), Total Nasal Symptom Score (TNSS), and Lund-Mackay Score. The dosage regimens vary from 10 to 40 mg triamcinolone acetonide. Only two cases of temporary visual complications were reported. CONCLUSION: This review found that intrapolyp steroid injection may be an effective and safe treatment for patients with nasal polyps. However, there exist no large, randomized, clinical trials. We found no association between dose and effect, or dose and the risk of visual complications.

Proceedings of the 2nd BEAT-PCD conference and 3rd PCD training school: part 1.

Primary ciliary dyskinesia (PCD) is a rare heterogenous condition that causes progressive suppurative lung disease, chronic rhinosinusitis, chronic otitis media, infertility and abnormal situs. 'Better Experimental Approaches to Treat Primary Ciliary Dyskinesia' (BEAT-PCD) is a network of scientists and clinicians coordinating research from basic science through to clinical care with the intention of developing treatments and diagnostics that lead to improved long-term outcomes for patients. BEAT-PCD activities are supported by EU funded COST Action (BM1407). The second BEAT-PCD conference, and third PCD training school were held jointly in April 2017 in Valencia, Spain. Presentations and workshops focussed on advancing the knowledge and skills relating to PCD in: basic science, epidemiology, diagnostic testing, clinical management and clinical trials. The multidisciplinary conference provided an interactive platform for exchanging ideas through a program of lectures, poster presentations, breakout sessions and workshops. Three working groups met to plan consensus statements. Progress with BEAT-PCD projects was shared and new collaborations were fostered. In this report, we summarize the meeting, highlighting developments made during the meeting.

Sinus bacteriology in patients with cystic fibrosis or primary ciliary dyskinesia: A systematic review.

BACKGROUND: A correlation exists between the microbial flora of the upper and lower airways in patients with cystic fibrosis (CF) or with primary ciliary dyskinesia (PCD). The sinuses can function as a bacterial reservoir where gram-negative bacteria adapt to the airways and repeatedly are aspirated to and colonize the lungs according to the theory of the united (unified) airways. Whereas the pattern of bacterial flora in the lower airways has been extensively studied, the upper airways have drawn limited attention. OBJECTIVE: Our aim was to review the literature that reported bacterial flora in the sinuses and nasal cavities of patients with CF or PCD. METHODS: A number of medical literature data bases were systematically searched between January 1960 and July 2016. We applied the following inclusion criteria: a minimum of one case of PCD (or Kartagener syndrome) or CF, and microbiology analyses from the nose or paranasal sinuses. RESULTS: We included 46 studies (1823 patients) from 16 countries. Staphylococcus aureus was found in 30% of the noses and sinuses of patients with CF. Other common bacteria found included Pseudomonas aeruginosa, coagulase negative staphylococci, and Haemophilus influenzae. In PCD, H. influenzae was the most common bacteria (28%), followed by Streptococcus pneumoniae and P. aeruginosa. If studies that included nonsurgical swab and blowing samples were excluded, then P. aeruginosa was the most common bacterium in patients with CF (34%) and in patients with PCD (50%), followed by S. aureus and H. influenza. CONCLUSION: S. aureus, P. aeruginosa, coagulase negative staphylococci, and H. influenzae dominated in the upper airways of patients with CF. In patients with PCD, H. influenzae, S. pneumoniae, and P. aeruginosa dominated. When studies that included swab and blowing samples were excluded, P. aeruginosa was the most common bacterium in both groups. Direct comparisons among the studies were restricted due to very heterogeneous methods, and a better standardization of procedures and outcomes is needed.