Sanan Akshay, Rabinowitz Mindy, Rosen Marc, Nyquist Gurston
Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Otolaryngol Clin North Am. 2017 Feb;50(1):129-141. doi: 10.1016/j.otc.2016.08.011.
Topical therapy has become an important tool in the otolaryngologist's armamentarium for refractory chronic rhinosinusitis (CRS). Daily high-volume sinonasal saline irrigation and standard metered-dose topical nasal steroid therapy are supported by the most evidence. Nonstandard topical sinonasal steroid therapies are a potential option for refractory CRS. Current evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using spray and nebulized techniques in routine cases of CRS. Stents are a new modality with preliminary data showing they are an option when traditional treatment has failed. Further research with long-term effects and outcomes studies for refractory CRS are needed.
局部治疗已成为耳鼻喉科医生治疗难治性慢性鼻-鼻窦炎（CRS）的重要手段。每日进行大容量鼻窦盐水冲洗和标准定量局部鼻用类固醇治疗最有证据支持。非标准的局部鼻窦类固醇疗法是难治性CRS的一种潜在选择。目前的证据不建议在CRS的常规病例中使用喷雾和雾化技术进行局部抗真菌治疗和局部抗生素治疗。支架是一种新的治疗方式，初步数据表明，当传统治疗失败时，支架是一种选择。需要对难治性CRS进行长期效果和结局研究的进一步研究。
