Introduction
While there is a growing trend to use corticosteroid nasal irrigation
instead of spray in
postoperative care after endoscopic sinus surgery (ESS)(1-8) ,
there is some, albeit very limited evidence that supports this
application as an initial treatment before sinus surgery as being the
superior method. A few previous studies investigated the concept of
sinus distribution on pre-surgical sinus cavities with the aim of
determining the most effective methods to deliver the medicine into the
sinus.(9-11) Unfortunately, the results from the studies could
not show any significant benefit of nasal irrigation in sinus
penetration. However, most studies were conducted in either healthy
subjects or cadavers, which could not represent the actual status of
pathological sinus cavities and dynamic physiology while rinsing the
sinus.(9, 10) Furthermore, one study examining sinus
penetration in unoperated chronic rhinosinusitis (CRS) patients used
low-volume nasal irrigation, which could not represent the ideal volume
to enhance sinus penetration even in the post-surgical sinus
status.(11)
Therefore, according to such knowledge gap, this study aims to compare
the sinus distribution of high-volume nasal irrigation and nasal spray
to determine the effective route for drug administration before sinus
surgery in CRS patients.