Hyo Yukiyoshi, Fujieda Shigeharu, Matsubara Atsushi, Takeuchi Kazuhiko, Ohki Motofumi, Shimizu Takeshi, Kurono Yuichi
Department of Otolaryngology - Head and Neck Surgery, Kawasaki Medical School, Kurashiki, Japan; HYO ENT Clinic, Kyoto, Japan.
Division of Otorhinolaryngology - Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan.
Auris Nasus Larynx. 2022 Jun;49(3):504-510. doi: 10.1016/j.anl.2021.11.007. Epub 2021 Nov 22.
Nebulizer therapy is an effective and safe topical treatment for rhinosinusitis and is frequently used by otolaryngologists in Japan. However, treatment methods used vary among regions and according to doctors' preferences. In this study, we aimed to investigate the use of nebulizer therapy for rhinosinusitis. Administration of nebulizer therapy has been affected by the coronavirus disease 2019 (COVID-19) pandemic. Thus, we also investigated the difference in the prevalence of nebulizer use before and during the pandemic.
Between February and September 2016 and in January 2021, we administered questionnaire surveys on nebulizer treatment for rhinosinusitis to otorhinolaryngologists, who were members of the Oto-Rhino-Laryngological Society of Japan, in Aomori, Saitama, Mie, Fukui, Shiga, Okayama, and Kagoshima prefectures.
More than 90% of the otorhinolaryngologists performed nebulizer treatment for rhinosinusitis in 2016. In April 2020 (the first wave of the COVID-19 pandemic), the use rate decreased to 20%, but in January 2021, the use rate increased to 60%. Jet nebulizers were the most frequently used type. One-third of the otolaryngologists enlarged the natural opening of the paranasal sinuses in more than half of their patients by using vasoconstrictors. Cefmenoxime and betamethasone were the most commonly used antibiotics and steroids, respectively.
Because it is important to perform nasal pretreatment and strict disinfection of nebulizer equipment, it is clear that education of otorhinolaryngologists as well as paramedical personnel is required to ensure safe and effective use of nebulizer therapy in Japan.
雾化治疗是一种治疗鼻窦炎的安全有效的局部治疗方法，在日本耳鼻喉科医生中经常使用。然而，不同地区和医生偏好所采用的治疗方法各不相同。在本研究中，我们旨在调查雾化治疗在鼻窦炎中的应用情况。雾化治疗的实施受到2019冠状病毒病（COVID-19）大流行的影响。因此，我们还调查了大流行之前和期间雾化器使用普及率的差异。
在2016年2月至9月期间以及2021年1月，我们对日本耳鼻喉科学会会员、青森县、埼玉县、三重县、福井县、滋贺县、冈山县和鹿儿岛县的耳鼻喉科医生进行了关于鼻窦炎雾化治疗的问卷调查。
2016年，超过90%的耳鼻喉科医生对鼻窦炎进行了雾化治疗。2020年4月（COVID-19大流行的第一波），使用率降至20%，但在2021年1月，使用率升至60%。喷射式雾化器是最常用的类型。三分之一的耳鼻喉科医生在超过半数的患者中使用血管收缩剂扩大鼻窦自然开口。头孢甲肟和倍他米松分别是最常用的抗生素和类固醇。
由于进行鼻腔预处理和对雾化器设备进行严格消毒很重要，显然在日本需要对耳鼻喉科医生以及医护人员进行培训，以确保安全有效地使用雾化治疗。
