Can Surfactant Be Used in Treatment of Rhinitis Medicamentosa? An Experimental Animal Study

• Main Authors: Melis Demirağ Evman, Hakan Avcı, Kayhan Başak, Murat Sarı
• Format: Article
• Language: English
• Published: KARE Publishing 2021-01-01
• Series: Southern Clinics of Istanbul Eurasia
• Subjects: surfactant or its combination with nasal steroid is not significantly effective in the treatment of rm.
• Online Access: https://jag.journalagent.com/z4/download_fulltext.asp?pdir=scie&un=SCIE-66934

INTRODUCTION[|]Rhinitis medicamentosa (RM) is a nonallergic form of rhinitis, mostly associated with prolonged, excessive, and improper use of topical decongestants. The only effective treatment for this is nasal steroids. This study aimed to reverse the mucosal changes in RM by the use of surfactant. Different molecules were applied to each group to compare surfactant's effectiveness.[¤]METHODS[|]Thirty rats were divided into five groups. All groups were treated with topical oxymetazoline 0.05% for 30 days. Loss of cilia, congestion, edema, goblet cell growth, and increase in mucous glands, squamous metaplasia, and chronic inflammatory cell infiltration were set as the main parameters. Rats in group 5 were sacrificed; all proved the presence of mucosal changes in compliance with RM. All groups were continued to be treated with oxymetazoline even during the histopathological examination period of 15 days. Treatment modalities of each group for 15 days were as follows: saline wash (0.09% NaCl) in group 1, mometasone furoate monohydrate 50 μg 0.05% in group 2, surfactant wash solution 1 drop/100 cc in group 3, and intranasal surfactant solution with mometasone furoate monohydrate 0.05% in group 4. All rats were decapitated and sent for histopathological evaluation at the end of day 60.[¤]RESULTS[|]A significant regression in the nasal mucosal congestion was found in groups treated with saline and mometasone furoate (p=0.005). No significant difference was found between groups when evaluating for regression of loss of cilia but unpredictably was seen in saline group by 83%. Surfactant/mometasone furoate combination therapy was found to be significantly ineffective for treatment of edema (p=0.013). No statistical difference was found between the groups in terms of chronic inflammatory cell infiltration (p=0.115). Squamous metaplasia was observed in all treatment groups, and there was no statistically significant difference between the groups (p=0.076).[¤]DISCUSSION AND CONCLUSION[|]Surfactant or its combination with nasal steroid is not significantly effective in the treatment of RM.[¤]