[Complications and side effects of conservative treatment of rhinological diseases]

BACKGROUND

The spectrum of rhinological diseases is wide, as is that of their drug-based treatment. Only 1272 compounds coded R01 (nasal preparations) are listed in the ATC group (Anatomical Therapeutic Chemical Classification). Conservative therapy of rhinological diseases additionally includes systemic (often oral) application of corticosteroids, antibiotics and immunomodulators.

OBJECTIVE

The aim of this paper is to outline possible complications of medication (subdivided into classes of ingredients) commonly used to treat rhinological diseases in hospitals. Useful therapeutic and preventive measures will be presented.

MATERIALS AND METHODS

Based on the expert information in the current pharmacological drug index (ATC) for the R01 group as well as literature research in the PubMed, Cochrane Library and MEDLINE databases, medication used for the treatment of rhinological diseases was analysed in terms of side effects and their frequency.

RESULTS

Common side effects of intranasally applied medication are local irritations, burning, dryness and epistaxis. Orally or intravenously applied rhinological medication can affect the organs and lead to side effects such as cardiac dysrhythmia or alterations of the blood count. It is recommended that the therapeutic be selected on an individual basis and that the patient be thoroughly informed about possible side effects.

CONCLUSION

Particularly when treating children or pregnant or breastfeeding women, the indications of all nasal preparations should be checked carefully. The huge variety of rhinologicals enables an optimal individual selection on the basis of consideration of known side effects.

Packing in endonasal surgery

Nasal packing is used to control bleeding in epistaxis and after endonasal surgery, for internal stabilization, and to prevent synechiae or restenosis, particularly after surgery. Generally accepted standards regarding the materials that should be used for packing, how long the packing should be left in place, or the indications for nasal packing are lacking. In view of the present lack of standardization and the many different packing materials used, we review the currently available materials and outline their respective properties, indications, and risks.