New Therapy May Ease Stubborn Sinusitis
By Janice Billingsley
HealthScoutNews Reporter, Yahoo! News, Sun Feb 2,11:55 PM
SUNDAY, Feb. 2 (HealthScoutNews) -- A new treatment for chronic sinusitis shows promise by delivering medication directly to the infected sinus tissues, a Stanford University study has shown.
A small, pilot study of 42 long-term sinusitis sufferers found that by sending the medication directly up the nose to the sinus, rather than taking medicines orally or intravenously, two-thirds of the patients were free of infection for an average of 17 weeks, triple the average six-week infection-free period when taking other treatments.
"Oral antibiotics and surgery are still very effective for the majority of patients with chronic sinusitis," says lead author Dr. Winston Vaughan, but he says that this new treatment can be effective "for the 10 to 20 percent 'failures' who continue to have multiple, horrid infections after surgery."
The study, which appeared in a recent issue of the journal Otolaryngology -- Head and Neck Surgery, was funded by Stanford University, where Vaughan is the director of the Sinus Center.
Vaughan is also a member of the scientific advisory board of SinusPharma, the parent company of SinusPharmacy, a Carpinteria, Calif., compounding pharmacy. SinusPharmacy is the only one offering the medication, a liquid form of the standard oral and intravenous antibiotics used in other treatments.
Dr. Christopher Shaari, an otolaryngologist at New Jersey's Hackensack University Medical Center, who is not affiliated with SinusPharmacy, has used the new treatment over the last year on approximately 20 patients, which represents about 15 percent of his chronic sinusitis caseload. He says the treatment is effective with patients for whom traditional therapies have failed.
"This is not a first-line treatment, but for patients with serious chronic sinusitis who have failed two or three oral antibiotics courses, or who have just had sinus surgery, it has been effective," he says. "The medication is delivered right to the site of the infection."
The treatment involves a machine called a nebulizer, which patients can hook up and use to send liquid medication through a tube directly up the nose to the lining of the sinuses. The treatment takes about 20 minutes and is done two or three times daily for three weeks.
For the study, the Stanford doctors recruited 28 women and 14 men, ages 23 to 84, most of whom had been treated for recurrent sinus infections, including surgery, for at least a year. The average time between recurrent infections was six weeks. They were given the equipment and taught to use it themselves for a three-week course of antibiotics.
At the end of a course of treatment, and after another three to seven months for follow-up examinations, 28 patients, or 66 percent, were free of infection. Six other of the study participants got rid of their infection but it returned with three months.
Of the remaining eight patients, six did not respond to the therapy and two dropped out of the study, which Vaughan says could be partially due to other health problems like overlying allergies.
"We have much more research to do on these and other patients," he says.
The doctors also found the treatment resulted in statistically significant drops in nasal discharge, facial pressure, and pain due to clogged sinuses.
The study authors point out that the study lacked a control group of those on standard sinus treatments so a possible placebo effect could not be discounted. Also needed in future studies are long-term effects of the therapy, and research into the actual interaction among the antibiotic, sinus mucus, and bacteria.
"We have started several studies looking at longer-term outcomes, and comparing the nebulizer treatment directly with IV and oral antibiotics," Vaughan says.