Arch Otolaryngol Head Neck Surg 2009 Mar;135(3):303-7
Division of Clinical Outcomes Research, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri 63110, USA.
Objectives: To evaluate whether nasal administration of budesonide in adults with chronic rhinosinusitis for 30 days suppresses adrenal function and to assess its clinical efficacy.
Design: An open-label prospective study.
Setting: Academic medical center.
Patients: We assessed adrenal function in 9 patients using the cosyntropin test before and after budesonide therapy.
Intervention: Budesonide respule therapy.
Main Outcome Measure: Scores from the Sino-Nasal Outcome Test-20 (SNOT-20), a tool for assessing rhinosinusitis health and quality of life, were used to assess efficacy of budesonide treatment.
Results: All of our patients showed adequate adrenal response to cosyntropin stimulation before and after the budesonide trial. The mean difference in SNOT-20 scores was -1 (95% confidence interval, -1.77 to -0.23; P = .02), indicating clinically significant improvement after therapy.
Conclusion: Our findings suggest that using budesonide nasal wash may be clinically effective in decreasing the symptoms of chronic rhinosinusitis and does so without suppression of the hypothalamic-pituitary-adrenal axis in patients with chronic rhinosinusitis.