Topical therapy with high-volume budesonide nasal irrigations in difficult-to-treat chronic rhinosinusitis

Braz J Otorhinolaryngol. Mar-Apr 2016;82(2):191-7. doi: 10.1016/j.bjorl.2015.03.014. Epub 2015 Sep 7.


Introduction: Chronic rhinosinusitis (CRS) is termed difficult-to-treat when patients do not reach acceptable level of control despite adequate surgery, intranasal corticosteroid treatment and up to 2 short courses of systemic antibiotics or corticosteroids in the preceding year. Recently, high-volume corticosteroid nasal irrigations have been recommended for CRS treatment.

Objective: To assess high-volume budesonide nasal irrigations for difficult-to-treat CRS.

Methods: Prospective uncontrolled intervention trial. Participants were assessed before- and 3 months after nasal irrigation with 1mg of budesonide in 500 mL of saline solution daily for 2 days. Subjective (satisfactory clinical improvement) and objective (SNOT-22 questionnaire and Lund-Kennedy endoscopic scores) assessments were performed.

Results: Sixteen patients were included, and 13 (81.3%) described satisfactory clinical improvement. SNOT-22 mean scores (50.2-29.6; p=0.006) and Lund-Kennedy mean scores (8.8-5.1; p=0.01) improved significantly. Individually, 75% of patients improved SNOT-22 scores, and 75% improved Lund-Kennedy scores after high volume budesonide nasal irrigations.

Conclusion: High-volume corticosteroid nasal irrigations are a good option in difficult-to-treat CRS control of disease, reaching 81.3% success control and significant improvement of SNOT-22 and Lund-Kennedy scores.

Keywords: Corticosteroides; Corticosteroids; Endoscopia; Endoscopy; Irrigação terapêutica; Nasal polyps; Pólipos nasais; Sinusite; Sinusitis; Therapeutic irrigations.

MeSH terms

  • Adult
  • Budesonide / administration & dosage*
  • Chronic Disease
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Nasal Lavage*
  • Prospective Studies
  • Rhinitis / drug therapy*
  • Sinusitis / drug therapy*
  • Treatment Outcome


  • Glucocorticoids
  • Budesonide