Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Am J Rhinol Allergy. 2013 May-Jun;27(3):177-80. doi: 10.2500/ajra.2013.27.3873.
Surfactants are a class of amphiphilic surface active compounds that show several unique physical properties at liquid-liquid or liquid-solid surface interfaces including the ability to increase the solubility of substances, lower the surface tension of a liquid, and decrease friction between two mediums. Because of these unique physical properties several in vitro, ex vivo, and human trials have examined the role of surfactants as stand-alone or adjunct therapy in recalcitrant chronic rhinosinusitis (CRS).
A review of the literature was performed.
The data from three different surfactants have been examined in this review: citric acid zwitterionic surfactant (CAZS; Medtronic ENT, Jacksonville FL), Johnson's Baby Shampoo (Johnson & Johnson, New Brunswick NJ), and SinuSurf (NeilMed Pharmaceuticals, Santa Rosa, CA). Dilute surfactant therapy shows in vitro antimicrobial effects with modest inhibition of bacterial biofilm formation. In patients with CRS, surfactants may improve symptoms, most likely through its mucolytic effects. In addition, surfactants have several distinct potential benefits including their ability to improve an irrigant's penetration of the nonoperated sinus and their synergistic effects with antibiotics. However, surfactants potential for nasal irritation and possible transient ciliotoxicity may limit their use.
Recent data suggest a possible therapeutic role of surfactants in treating rhinopathologies associated with mucostasis. Further investigation, including a standardization of surfactant formulations, is warranted to further elucidate the potential benefits and drawbacks of this therapy.
表面活性剂是一类两亲性表面活性化合物，在液-液或液-固界面上表现出多种独特的物理性质，包括增加物质溶解度、降低液体表面张力和降低两种介质之间摩擦力的能力。由于这些独特的物理性质，一些体外、离体和人体试验研究了表面活性剂作为单一或辅助疗法在难治性慢性鼻-鼻窦炎（CRS）中的作用。
对文献进行了回顾。
本综述检查了三种不同的表面活性剂的数据：柠檬酸两性离子表面活性剂（CAZS；Medtronic ENT，杰克逊维尔，佛罗里达州）、强生婴儿洗发水（强生，新泽西州新不伦瑞克）和 SinuSurf（NeilMed Pharmaceuticals，圣罗莎，加利福尼亚州）。稀释表面活性剂疗法具有体外抗菌作用，适度抑制细菌生物膜形成。在 CRS 患者中，表面活性剂可能通过其粘液溶解作用改善症状。此外，表面活性剂具有几个明显的潜在益处，包括改善冲洗液在未手术鼻窦中的渗透能力及其与抗生素的协同作用。然而，表面活性剂可能引起鼻腔刺激和潜在的短暂纤毛毒性，这可能限制了其使用。
最近的数据表明，表面活性剂在治疗与粘液阻塞相关的鼻病方面可能具有治疗作用。需要进一步的研究，包括表面活性剂配方的标准化，以进一步阐明这种治疗的潜在益处和缺点。
