Topical drug delivery for the treatment of inflammation of the lining of the nose and paranasal sinuses has been widely practiced for many years. For instance, inhaled nasal steroids are commonly used for the treatment of allergic rhinitis.
Topical medications may also be prescribed through a compounding pharmacy for the treatment of chronic rhinosinusitis, especially after sinus surgery. The drugs may be delivered to the sinuses via irrigation or nebulization. After sinus surgery, irrigation with saline serves to wash away thick mucus and other debris that otherwise may accumulate in sinus cavities. The irrigation may also be a carrier for the delivery of drugs (especially steroids) deep into the sinus spaces as a way to reduce inflammation of the sinus lining.
Exhalation delivery technology is another method for delivering drug “high and deep” into the nose and sinuses. This approach maximizes the amount of drug on the target tissue and minimizes systemic absorption and side effects. Currently, exhalation delivery is available for fluticasone, a topical steroid with a long track record of both safety and effectiveness. In select patients, exhalation delivery of fluticasone reduces polyp size and patient systems–with minimal risk of systemic side effects.