{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:58:35Z","timestamp":1785776315523,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are commonly treated with intranasal corticosteroid sprays. Despite their efficacy, unpleasant sensations associated with their application, including post\u2010nasal drip and nasal irritation, are often cited as reasons for poor compliance. Optimising the intranasal application experience is key to improving long\u2010term adherence. We developed a nasal adaptor for metered\u2010dose inhalers (MDIs) to reduce the unpleasantness of nasal administration, potentially improving patient compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Two crossover trials were conducted in AR and postoperative CRS participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916 per group). Participants used a standard fluticasone nasal spray (50\u2009\u03bcg) and a fluticasone MDI (125\u2009\u03bcg) with the adaptor for 3\u2009weeks each, separated by a 1\u2010week washout period. Device order was alternated, and doses were adjusted to ensure an approximately equal fluticasone dose. Device preference was determined using an adjusted Clinical Trial Patient Preference Questionnaire, and symptom improvement was assessed using Total Nasal Symptom Score and Sino\u2010nasal Outcome Test\u201022 questionnaires.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Symptom improvement was comparable between the devices. However, in both groups, 11\/16 (69%) participants preferred the MDI with the adaptor over the standard nasal spray, citing fewer unpleasant sensations. Satisfaction score improvement was significantly greater with the novel device in the CRS cohort. Participants reported a higher likelihood of compliance with the novel device, suggesting improved adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An MDI with the adaptor was preferred over a standard nasal spray among AR and postoperative CRS participants. The enhanced tolerability may promote improved compliance, and consequently, more effective long\u2010term symptom control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70137","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:35:13Z","timestamp":1782545713000},"page":"776-783","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel Device to Improve the Tolerability of Intranasal Corticosteroid Sprays for Allergic Rhinitis and Postoperative Chronic Rhinosinusitis: A Crossover Trial"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2720-2812","authenticated-orcid":false,"given":"Sethmi","family":"Ranasinghe","sequence":"first","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"},{"name":"Te Whatu Ora, Health New Zealand  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xenia","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wandia","family":"Kimita","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"},{"name":"Te Whatu Ora, Health New Zealand  Auckland New Zealand"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Auckland City Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Douglas","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"},{"name":"Te Whatu Ora, Health New Zealand  Auckland New Zealand"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Auckland City Hospital  Auckland New 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