Varricchio Attilio, Presutti Livio, La Mantia Ignazio, Varricchio Antonio, Ciprandi Giorgio
University of Molise.
University of Bologna.
Multidiscip Respir Med. 2024 Dec 3;19(1):993. doi: 10.5826/mrm.2024.993.
Topical nasal therapy represents a widespread opportunity to treat upper airway diseases. As a result, specialists in different areas (mainly ENT, pediatrics, and allergology) and general practitioners prescribe intranasal compounds. However, a myriad of products and devices are available, as well as respiratory disorders. Consequently, this matter is debatable, and no guideline organically addresses this issue. Considering these premises, a restricted panel of qualified experts promoted an initial multidisciplinary survey involving only Fellows of some Scientific Societies belonging to ENT, pediatrics, and allergology areas. The survey included a series of queries concerning practical aspects of topical nasal therapy (treated disease, devices, and agents). A web platform served to participate in this survey. Each participant anonymously completed the questionnaire. Four hundred and forty-five doctors participated in the survey. There was a homogeneous distribution in Italy. Most participants were pediatricians (37%), followed by allergologists (31%) and ENT specialists (24%). Almost all doctors (95%) used topical nasal therapy. The most common diseases topically treated were allergic rhinitis (79%), chronic rhinosinusitis (73%), and non-allergic rhinitis. The most popular devices were pre-dosed spray both for nasal irrigation (67%) and nebulization (66%). Corticosteroids (67%), isotonic saline (63%), hyaluronic acid, hypertonic saline, and antihistamines (39%) were the most common agents used for intranasal therapy. Combined antihistamine/corticosteroids were also commonly used (38%). The most frequent schedule was the cyclic treatment. Most doctors (89%) claim they adequately spend time educating patients on this matter. In conclusion, topical nasal therapy is commonly used to manage upper respiratory diseases. However, the disagreement about some issues requires greater knowledge of the topics and the need to develop new studies, including pragmatic ones.
局部鼻腔治疗为治疗上呼吸道疾病提供了广泛的机会。因此,不同领域的专家(主要是耳鼻喉科、儿科和过敏科)以及全科医生都会开具鼻内用药。然而,市面上有大量的产品和器械,同时也存在多种呼吸道疾病。因此,这个问题存在争议,且没有指南能系统地解决这一问题。基于这些前提,一个由合格专家组成的有限小组发起了一项初步的多学科调查,仅涉及耳鼻喉科、儿科和过敏科领域一些科学协会的会员。该调查包括一系列关于局部鼻腔治疗实际方面的问题(所治疗的疾病、器械和药物)。一个网络平台用于参与此次调查。每位参与者匿名完成问卷。445名医生参与了此次调查。参与者在意大利分布均匀。大多数参与者是儿科医生(37%),其次是过敏科医生(31%)和耳鼻喉科专家(24%)。几乎所有医生(95%)都使用局部鼻腔治疗。局部治疗最常见的疾病是过敏性鼻炎(79%)、慢性鼻 - 鼻窦炎(73%)和非过敏性鼻炎。最受欢迎的器械是用于鼻腔冲洗(67%)和雾化(66%)的预定量喷雾。皮质类固醇(67%)、等渗盐水(63%)、透明质酸、高渗盐水和抗组胺药(39%)是鼻内治疗最常用的药物。抗组胺药/皮质类固醇联合用药也很常用(38%)。最常见的用药方案是循环治疗。大多数医生(89%)声称他们在这个问题上会花足够的时间对患者进行教育。总之,局部鼻腔治疗常用于管理上呼吸道疾病。然而,在一些问题上存在的分歧需要对这些主题有更深入的了解,并且需要开展新的研究,包括实用性研究。