The efficacy of diluted topical povidone-iodine rinses in the management of recalcitrant chronic rhinosinusitis: a prospective cohort study

• Published in: European archives of oto-rhino-laryngology 2019-12, Vol.276 (12), p.3373-3381
• Main Authors: Panchmatia, Rikesh, Payandeh, Jennifer, Al-Salman, Rami, Kakande, Emily, Habib, Al-Rahim, Mullings, Warren, Javer, Amin R.
• Format: Article
• Language: English
• Subjects: Administration, Intranasal; Adult; Anti-Infective Agents, Local - administration & dosage; Anti-Infective Agents, Local - therapeutic use; Chronic Disease; Cohort Studies; Endoscopy; Female; Head and Neck Surgery; Humans; Inflammation - drug therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Mucociliary Clearance; Nasal Lavage; Neurosurgery; Otorhinolaryngology; Povidone-Iodine - administration & dosage; Povidone-Iodine - therapeutic use; Prospective Studies; Rhinitis - drug therapy; Rhinitis - surgery; Rhinology; Severity of Illness Index; Sinusitis - drug therapy; Sinusitis - surgery; Therapeutic Irrigation; Treatment Outcome
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-019-05628-w

Purpose Recalcitrant chronic rhinosinusitis is a persistent inflammatory condition of the sinonasal mucosa despite adequate medical therapy and sinus surgery. This study aimed to demonstrate the effectiveness and safety of dilute povidone-iodine (PVP-I) sinonasal rinses as an adjunctive therapy. Methods Prospective cohort study. Twenty-nine recalcitrant CRS patients with endoscopic evidence of ongoing inflammation and purulent discharge were prescribed 0.08% diluted PVP-I rinses. Changes to endoscopic modified Lund–Kennedy (MLK) scores at 7 weeks post-PVP-I rinsing served as the primary outcome measure. Results The median MLK-discharge score significantly decreased in all patients by 1.50 points post-PVP-I rinsing ( p value  12; baseline median = 33; follow-up median = 20; p value