{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T21:41:47Z","timestamp":1787866907197,"version":"build-2784847793"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,12,17]],"date-time":"2015-12-17T00:00:00Z","timestamp":1450310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Nasal steroids are a critical part of the management of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) after endoscopic sinus surgery (ESS). Increasingly, practitioners are using budesonide respules delivered to the sinonasal cavities, which is an off\u2010label use, in lieu of traditional nasal steroids. There has been little research comparing budesonide with traditional nasal steroids and the most effective delivery method of budesonide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized controlled trial was performed on patients after ESS for CRSwNP in a tertiary care center. Patients were randomized into 1 of 3 groups: group A received fluticasone nasal spray twice daily; group B received budesonide respules via a mucosal atomization device (MAD) twice daily; and group C received budesonide respules instilled via the vertex\u2010to\u2010floor (VF) position twice daily. Primary endpoints were 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022) and Lund\u2010Kennedy scores at 6 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010two patients were enrolled in the study, 23 of whom completed the 6\u2010month trial. There were no significant differences among groups A, B, and C with respect to age, gender, asthma, aspirin sensitivity, or previous ESS. Group B had a statistically significant greater reduction in SNOT\u201022 and Lund\u2010Kennedy scores at the primary endpoint of 6 months compared to groups A and C. Group C had the next greatest reduction, which was statistically significant, followed by group A.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients treated with budesonide after ESS for CRSwNP had greater improvement in SNOT\u201022 and Lund\u2010Kennedy scores compared to fluticasone at 6 months. The data supports the use of budesonide respules, particularly with a MAD, over fluticasone for CRSwNP patients after ESS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21688","type":"journal-article","created":{"date-parts":[[2015,12,17]],"date-time":"2015-12-17T16:06:00Z","timestamp":1450368360000},"page":"233-237","source":"Crossref","is-referenced-by-count":49,"title":["Comparison of intranasal fluticasone spray, budesonide atomizer, and budesonide respules in patients with chronic rhinosinusitis with polyposis after endoscopic sinus surgery"],"prefix":"10.1002","volume":"6","author":[{"given":"Paul D.","family":"Neubauer","sequence":"first","affiliation":[{"name":"Section of Otolaryngology, Department of Surgery Yale School of Medicine  New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary G.","family":"Schwam","sequence":"additional","affiliation":[{"name":"Yale School of Medicine  New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Peter","family":"Manes","sequence":"additional","affiliation":[{"name":"Section of Otolaryngology, Department of Surgery Yale School of Medicine  New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,12,17]]},"reference":[{"issue":"23","key":"e_1_2_6_2_1","first-page":"1","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2012","author":"Fokkens WJ","year":"2012","journal-title":"Rhinol Suppl"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2010.04.003"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.03.009"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24066"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21096"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21280"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.07.039"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.01995.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949510410s02"},{"key":"e_1_2_6_11_1","unstructured":"Fluticasone nasal spray.https:\/\/www.nlm.nih.gov\/medlineplus\/druginfo\/meds\/a695002.html."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.05.628"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23259"},{"key":"e_1_2_6_14_1","first-page":"CD006549","article-title":"Topical steroids for nasal polyps","volume":"12","author":"Kalish L","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21180"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2008.555"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22396"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2006.20.2904"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2008.01750.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2000.00932.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2000.00695.x"},{"key":"e_1_2_6_22_1","unstructured":"Pulmicort Respules Prices Coupons and Patient Assistance Programs.http:\/\/www.drugs.com\/price\u2010guide\/pulmicort\u2010respules. 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