{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:13:27Z","timestamp":1761059607769},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,10,2]],"date-time":"2013-10-02T00:00:00Z","timestamp":1380672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Richie's Specialty Pharmacy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Intranasal corticosteroid irrigations, especially budesonide, are used increasingly in the management of chronic rhinosinusitis. In post\u2013endoscopic sinus surgery patients, irrigations may offer improved delivery at higher doses to the paranasal sinuses than intranasal spray preparations. Fluticasone propionate may have higher potency and lower systemic bioavailability than budesonide, but there is little data on its effects as an intranasal irrigation on the hypothalamic\u2010pituitary\u2010adrenal axis or on ocular findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients who had previously undergone bilateral endoscopic sinus surgery and had not taken systemic corticosteroids in the last 6 months were prospectively enrolled. Subjects irrigated with 3 mg of fluticasone propionate in 240 mL saline solution twice daily. Salivary cortisol, intraocular pressure, and the presence of posterior subcapsular cataracts were measured before drug administration and after 6 weeks of continuous use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three subjects completed the study. No subjects had salivary cortisol levels below the normal range before or after therapy, and there was no statistical difference in mean salivary cortisol levels pretreatment and posttreatment (0.294 vs 0.392 \u03bcg\/dL; <jats:italic>p<\/jats:italic> = 0.27). There was no clinical or statistical difference in mean intraocular pressure before or after therapy (13.3 vs 13.3 mmHg; <jats:italic>p<\/jats:italic> = 0.86). No subjects developed a posterior subcapsular cataract.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fluticasone propionate irrigations did not suppress salivary cortisol levels or result in ocular changes. Irrigation with fluticasone propionate 3 mg in 240 mL saline twice daily may be a safe alternative to other intranasal or systemic corticosteroid treatments for chronic rhinosinusitis patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21228","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T01:30:25Z","timestamp":1381541425000},"page":"953-957","source":"Crossref","is-referenced-by-count":28,"title":["The effect of intranasal fluticasone propionate irrigations on salivary cortisol, intraocular pressure, and posterior subcapsular cataracts in postsurgical chronic rhinosinusitis patients"],"prefix":"10.1002","volume":"3","author":[{"given":"Li\u2010Xing","family":"Man","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Rochester  Rochester NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Farhood","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery The University of Texas Medical School at Houston  Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Luong","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery The University of Texas Medical School at Houston  Houston TX"},{"name":"Texas Sinus Institute The University of Texas Medical School at Houston  Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samer","family":"Fakhri","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery The University of Texas Medical School at Houston  Houston TX"},{"name":"Texas Sinus Institute The University of Texas Medical School at Houston  Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Ruiz Department of Ophthalmology and Visual Science The University of Texas Medical School at Houston  Houston TX"},{"name":"Robert Cizik Eye Clinic The University of Texas Medical School at Houston  Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip R.","family":"Orlander","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Diabetes and Metabolism Department of Internal Medicine The University of Texas Medical School at Houston  Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin J.","family":"Citardi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery The University of Texas Medical School at Houston  Houston TX"},{"name":"Texas Sinus Institute The University of Texas Medical School at Houston  Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,10,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2010.04.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.58"},{"issue":"11","key":"e_1_2_7_4_1","first-page":"1","article-title":"Ambulatory surgery in the United States, 2006","author":"Cullen KA","year":"2009","journal-title":"Natl Health Stat Report"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810391852"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.04.020"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2009.07.005"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.03.009"},{"key":"e_1_2_7_9_1","first-page":"821","article-title":"Safety of budesonide in saline sinonasal irrigations in the management of chronic rhinosinusitis with polyposis: lack of significant adrenal suppression","volume":"37","author":"Bhalla RK","year":"2008","journal-title":"J Otolaryngol Head Neck Surg."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2008.555"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2010.24.3418"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21047"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2008.01750.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(98)70155-1"},{"key":"e_1_2_7_15_1","unstructured":"U.S. Food and Drug Administration.Guidance for Industry. 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