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IS THERE A CORRELATION BETWEEN IMPROPER USE OF INTRANASAL CORTICOSTEROIDS AND THEIR SIDE EFFECTS?

Labeb Sailan, Saad AlSaleh, Nora AlHelali, Sarah AlSeneidi, Muhannad AlSharidah.

Background: The current guidelines recommend the use of intranasal corticosteroids (INCS) as the first-line treatment for allergic rhinitis(AR), chronic rhinosinusitis(CRS) and acute rhinosinusitis(ARS). INCS is associated with various topical side effects in 5%–10% of patients. Improper technique of administration is a major factor that influences the incidence of adverse effects of INCS, therefore patient education about the proper technique of administration of these agents is imperative. Objective: To find out whether improper use of INCS will lead to increase the incidence of their side effects. Methods: It is a cross-sectional study conducted at the rhinology clinic of king AbdulAziz university hospital, Riyadh, KSA, over a 6-month in the period extending from February to August 2018, where the questionnaire distributed for patients who are using INCS. Data analysis was performed using Statistical Package for the Social Sciences software. Results: A total of 150 patients responded for the questionnare. 97.3% reported the use of the right hand for spraying both nostrils, 2% use of the ipsilateral hand for spraying and none them use the contralateral technique. Only 5.3% of the patients directed the nozzle of the dispenser away from the septum (proper technique), whereas the remaining 94.7% patients reported aiming the nozzle in the improper direction (toward the septum or in a straight(parasagital) direction). Improperly directed spray was significantly associated with nasal dryness (P = 0.008) but not with epistaxis and pain. Conclusion: Improperly directed nozzle of INCS is associated with higher incidence of nasal dryness Key words: Corticosteroids, rhinosinusitis, nasal spray, side effects.

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