Otolaryngology–Head and Neck Surgery
Volume 160, Issue 3 pp. 429-438
Review Articles
Shana M. Zucker, Shana M. Zucker Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA Search for more papers by this author Blair M. Barton MD Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA Search for more papers by this author Corresponding Author Edward D. McCoul MD, MPH Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA Ochsner Clinical School, School of Medicine, University of Queensland, New Orleans, Louisiana, USA Corresponding Author: Edward D. McCoul, MD, MPH, Department of Otorhinolaryngology, Ochsner Clinic Foundation, 1514Jefferson Hwy, CT4, New Orleans, LA 70121, USA. Email: [emailprotected]Search for more papers by this author
Shana M. Zucker, Shana M. Zucker Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA Search for more papers by this author Blair M. Barton MD Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA Search for more papers by this author Corresponding Author Edward D. McCoul MD, MPH Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA Ochsner Clinical School, School of Medicine, University of Queensland, New Orleans, Louisiana, USA Corresponding Author: Edward D. McCoul, MD, MPH, Department of Otorhinolaryngology, Ochsner Clinic Foundation, 1514Jefferson Hwy, CT4, New Orleans, LA 70121, USA. Email: [emailprotected]Search for more papers by this author
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
This article was presented as a poster at the 2018 Triological Combined Sections Meeting; January 18-20, 2018; Scottsdale, Arizona.
Abstract
Objective
Rhinitis medicamentosa (RM) is a common condition resulting from overuse of topical nasal decongestants. Despite the prevalence in otolaryngologic practice, a clear treatment protocol has not been established. Our objective was to review the current published literature pertaining to the treatment of RM with the possibility of finding data that support one treatment over another.
Data Sources
PubMed, Embase, Cochrane, and Web of Science databases were examined for patients diagnosed with RM resulting from chronic use of topical nasal decongestants.
Review Methods
The PRISMA standard (Preferred Reporting Items for Systematic Reviews and Meta-analyses) was utilized to identify English-language studies reporting treatment of patients with the primary diagnosis of RM after chronic use of a topical decongestant. Outcome measures of interest included patient-reported symptom relief and objective parameters. MINORS criteria (methodological index for nonrandomized studies) were used to assess the quality of articles.
Results
A total of 350 articles were identified, 9 of which met final inclusion criteria for qualitative analysis. Outcomes defined in each publication were highly varied and relied on several unstandardized measures. The most commonly reported treatment option was topical nasal steroids, although overall there was limited evidence on which to base treatment recommendation.
Conclusions
There is not adequate evidence to develop a standardized treatment protocol for RM. The development of a uniform questionnaire, standard outcomes to be measured, and a method of assessing such outcomes is necessary. Prospective randomized controlled studies are warranted to determine the optimal treatment regimen following diagnosis of RM.
References
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Volume160, Issue3
March 2019
Pages 429-438
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