Effectiveness of Budesonide Nasal Instillation in a Vertex-to-floor Position

NCT ID: NCT02862509

Last Updated: 2016-08-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-30

Study Completion Date

2017-08-31

Brief Summary

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o Chronic rhinosinusitis is one of the most common health issue affected American population. Surgery plays an important role in the patients who failed the medical treatment. The most difficult location to be operated endoscopically is the frontal sinus. Frontal sinus is also found to be one of the most common sinus for residual and recurrence after the operation. Intranasal steroid seems to be one of the most beneficent post-sinus surgery cares. The topical therapy can be delivered by many approaches. According to the standard clinical practice guideline and recommendations, intranasal corticosteroid spray is suggested. The technique proved to have greater distribution than standard intranasal spray is instillation of steroid nose drops. The head position for instillation of steroid nose drops proven to have a greater access to olfactory cleft and frontal area is Vertex-to-floor position.

Detailed Description

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Conditions

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Chronic Frontal Rhinosinusitis Vertex to Floor Position

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Budesonide nasal instillation

budesonide(0.5mg/2ml) 1 respule plus normal saline solution 120ml instilled in vertex to floor position daily

Group Type EXPERIMENTAL

Budesonide nasal instillation

Intervention Type DRUG

Normal saline nasal instillation

Normal saline solution instilled in vertex to floor position daily

Group Type PLACEBO_COMPARATOR

Normal saline nasal instillation

Intervention Type DRUG

Interventions

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Budesonide nasal instillation

Intervention Type DRUG

Normal saline nasal instillation

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Chronic rhinosinusitis with frontal sinusitis patient
* Age ≥12
* Post-frontal sinus surgery with frontal sinus opening\>3mm
* Satisfactory surgical technique: adequate sinus osteal drainage and mucosal sparing technique

Exclusion Criteria

* Isolated frontal sinus surgery
* History of previous head and neck radiation
* Previous nasal or sinus operation
* Clinically significant deviated nasal septum
* History of paranasal sinus tumor
* Known immunocompromised Host
* History of budesonide allergy
* Cannot provide full flexion of the neck (cannot perform vertex-to-floor position)
* Post-randomization exclusion: Pathologic invasive fungal infection
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Khon Kaen University

OTHER

Sponsor Role lead

Responsible Party

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Navarat Vatcharayothin

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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King Chulalongkorn Memorial Hospital

Bangkok, Bangkok, Thailand

Site Status

Srinagarind Hospital

Khon Kaen, Changwat Khon Kaen, Thailand

Site Status

Countries

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Thailand

References

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Halawi AM, Smith SS, Chandra RK. Chronic rhinosinusitis: epidemiology and cost. Allergy Asthma Proc. 2013 Jul-Aug;34(4):328-334. doi: 10.2500/aap.2013.34.3675.

Reference Type RESULT
PMID: 23883597 (View on PubMed)

Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 10. 2014 Feb;(260):1-161.

Reference Type RESULT
PMID: 24819891 (View on PubMed)

Bhattacharyya N. Incremental health care utilization and expenditures for chronic rhinosinusitis in the United States. Ann Otol Rhinol Laryngol. 2011 Jul;120(7):423-7. doi: 10.1177/000348941112000701.

Reference Type RESULT
PMID: 21859049 (View on PubMed)

Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, Cohen N, Cervin A, Douglas R, Gevaert P, Georgalas C, Goossens H, Harvey R, Hellings P, Hopkins C, Jones N, Joos G, Kalogjera L, Kern B, Kowalski M, Price D, Riechelmann H, Schlosser R, Senior B, Thomas M, Toskala E, Voegels R, Wang de Y, Wormald PJ. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012 Mar;50(1):1-12. doi: 10.4193/Rhino12.000.

Reference Type RESULT
PMID: 22469599 (View on PubMed)

Grobler A, Weitzel EK, Buele A, Jardeleza C, Cheong YC, Field J, Wormald PJ. Pre- and postoperative sinus penetration of nasal irrigation. Laryngoscope. 2008 Nov;118(11):2078-81. doi: 10.1097/MLG.0b013e31818208c1.

Reference Type RESULT
PMID: 18641522 (View on PubMed)

Musy PY, Kountakis SE. Anatomic findings in patients undergoing revision endoscopic sinus surgery. Am J Otolaryngol. 2004 Nov-Dec;25(6):418-22. doi: 10.1016/j.amjoto.2004.06.002.

Reference Type RESULT
PMID: 15547811 (View on PubMed)

Harvey RJ, Goddard JC, Wise SK, Schlosser RJ. Effects of endoscopic sinus surgery and delivery device on cadaver sinus irrigation. Otolaryngol Head Neck Surg. 2008 Jul;139(1):137-42. doi: 10.1016/j.otohns.2008.04.020.

Reference Type RESULT
PMID: 18585576 (View on PubMed)

Miller TR, Muntz HR, Gilbert ME, Orlandi RR. Comparison of topical medication delivery systems after sinus surgery. Laryngoscope. 2004 Feb;114(2):201-4. doi: 10.1097/00005537-200402000-00004.

Reference Type RESULT
PMID: 14755189 (View on PubMed)

Harvey RJ, Debnath N, Srubiski A, Bleier B, Schlosser RJ. Fluid residuals and drug exposure in nasal irrigation. Otolaryngol Head Neck Surg. 2009 Dec;141(6):757-61. doi: 10.1016/j.otohns.2009.09.006.

Reference Type RESULT
PMID: 19932850 (View on PubMed)

Hardy JG, Lee SW, Wilson CG. Intranasal drug delivery by spray and drops. J Pharm Pharmacol. 1985 May;37(5):294-7. doi: 10.1111/j.2042-7158.1985.tb05069.x.

Reference Type RESULT
PMID: 2862235 (View on PubMed)

Aoki FY, Crowley JC. Distribution and removal of human serum albumin-technetium 99m instilled intranasally. Br J Clin Pharmacol. 1976 Oct;3(5):869-78. doi: 10.1111/j.1365-2125.1976.tb00640.x.

Reference Type RESULT
PMID: 973982 (View on PubMed)

Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol. 2009 Oct;34(5):447-54. doi: 10.1111/j.1749-4486.2009.01995.x.

Reference Type RESULT
PMID: 19793277 (View on PubMed)

Snidvongs K, Dalgorf D, Kalish L, Sacks R, Pratt E, Harvey RJ. Modified Lund Mackay Postoperative Endoscopy Score for defining inflammatory burden in chronic rhinosinusitis. Rhinology. 2014 Mar;52(1):53-59. doi: 10.4193/Rhino13.056.

Reference Type RESULT
PMID: 24618629 (View on PubMed)

Other Identifiers

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HE581299

Identifier Type: -

Identifier Source: org_study_id

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