Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis

Warren Mullings; Rikesh Panchmatia; Katrien Samoy; Al-Rahim Habib; Andrew Thamboo; Rami Al-Salman; Amin Javer

doi:10.5152/ejra.2019.166

Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis

Abstract

Objective: Recalcitrant chronic rhinosinusitis (CRS) is a persistent inflammation of the sino-nasal mucosa despite appropriate medical therapy and sinus surgery. The aim of the present study was to demonstrate the effect of topical povidone-iodine (PVP-I) sinus rinses on modified Lund–Kennedy (MLK) endoscopic scores. Material and Methods: Retrospective chart review of patients with recalcitrant CRS (n=69) previously prescribed 0.08% adjunctive PVP-I sino-nasal rinses to evaluate changes in MLK scores and in the 22-item Sino-Nasal Outcome Test (SNOT-22) and a prospective cohort study lasting 7 weeks (n=17) were used to investigate safety outcomes. Results: Mean total MLK decreased by 2.01 points (p<0.05, n=69) and median MLK-discharge decreased by 1.50 points (p<0.05, n=69) retrospectively. When MLK-discharge improved, 71% also had a reduction in edema. When MLK-discharge did not change, 42% had a reduction in edema. The efficacy of PVP-I on total MLK score reduction was greatest by the first follow-up visit at a median of 46 days, with sustained benefit thereafter not limited by gender, baseline disease severity, CRS subtype, duration of PVP-I use, or by concurrent antibiotic or antifungal use. Subjective SNOT-22 scores significantly improved by a minimal clinically important difference factor of 2.9 (p=0.02, n=15). Median thyroid-stimulating hormone (TSH) levels changed non-significantly (p=0.1, n=15) within normal ranges prospectively. Median mucociliary clearance time changed non-significantly (p=0.53, n=17) within normal ranges. Conclusion: Ancillary 0.08% PVP-I sino-nasal rinses appear to reduce the endoscopic signs of inflammation and patient-reported symptomatology, while minimally affecting thyroid and mucociliary function. A larger scale randomized controlled trial incorporating microbiology associations is required to corroborate these findings.

Keywords

References

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Details

Primary Language

English

Subjects

Otorhinolaryngology

Journal Section

Research Article

Authors

Warren Mullings This is me
0000-0002-9817-0491
Canada

Rikesh Panchmatia This is me
0000-0002-7310-2900
Canada

Katrien Samoy This is me
0000-0002-0182-6264
Canada

Al-Rahim Habib This is me
0000-0001-6327-4648
Canada

Andrew Thamboo This is me
0000-0002-3910-2253
Canada

Rami Al-Salman This is me
0000-0002-6587-912X
Canada

Amin Javer This is me
0000-0003-3116-6559
Canada

Publication Date

October 8, 2019

Submission Date

July 22, 2019

Acceptance Date

September 2, 2019

Published in Issue

Year 2019 Volume: 2 Number: 2

DOI

https://doi.org/10.5152/ejra.2019.166

IZ

https://izlik.org/JA76AN54HY

Cite

RIS / Bibtex

APA

Mullings, W., Panchmatia, R., Samoy, K., Habib, A.-R., Thamboo, A., Al-Salman, R., & Javer, A. (2019). Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis. European Journal of Rhinology and Allergy, 2(2), 45-50. https://doi.org/10.5152/ejra.2019.166

AMA

1.Mullings W, Panchmatia R, Samoy K, et al. Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis. Eur J Rhinol Allergy. 2019;2(2):45-50. doi:10.5152/ejra.2019.166

Chicago

Mullings, Warren, Rikesh Panchmatia, Katrien Samoy, et al. 2019. “Topical Povidone-Iodine As an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis”. European Journal of Rhinology and Allergy 2 (2): 45-50. https://doi.org/10.5152/ejra.2019.166.

EndNote

Mullings W, Panchmatia R, Samoy K, Habib A-R, Thamboo A, Al-Salman R, Javer A (October 1, 2019) Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis. European Journal of Rhinology and Allergy 2 2 45–50.

IEEE

[1]W. Mullings et al., “Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis”, Eur J Rhinol Allergy, vol. 2, no. 2, pp. 45–50, Oct. 2019, doi: 10.5152/ejra.2019.166.

ISNAD

Mullings, Warren - Panchmatia, Rikesh - Samoy, Katrien - Habib, Al-Rahim - Thamboo, Andrew - Al-Salman, Rami - Javer, Amin. “Topical Povidone-Iodine As an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis”. European Journal of Rhinology and Allergy 2/2 (October 1, 2019): 45-50. https://doi.org/10.5152/ejra.2019.166.

JAMA

1.Mullings W, Panchmatia R, Samoy K, Habib A-R, Thamboo A, Al-Salman R, Javer A. Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis. Eur J Rhinol Allergy. 2019;2:45–50.

MLA

Mullings, Warren, et al. “Topical Povidone-Iodine As an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis”. European Journal of Rhinology and Allergy, vol. 2, no. 2, Oct. 2019, pp. 45-50, doi:10.5152/ejra.2019.166.

Vancouver

1.Warren Mullings, Rikesh Panchmatia, Katrien Samoy, Al-Rahim Habib, Andrew Thamboo, Rami Al-Salman, Amin Javer. Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis. Eur J Rhinol Allergy. 2019 Oct. 1;2(2):45-50. doi:10.5152/ejra.2019.166