An evaluation of the best head position for instillation of steroid nose drops

An evaluation of the best head position for instillation of steroid nose drops Steroid nose drops are used frequently to treat rhinosinusitis and nasal polyposis. The middle meatal area is of key importance in the pathophysiology of these conditions. This study assesses which of three head positions...

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Bibliographic Details
Published in:Clinical otolaryngology and allied sciences 2002-01, Vol.27 (1), p.18-21
Main Authors: KAYARKAR, R., CLIFTON, N.J., WOOLFORD, T.J.
Format: Article
Language:English
Subjects:
Administration, Intranasal
Adult
Anti-Inflammatory Agents - administration & dosage
Betamethasone - administration & dosage
discomfort
distribution
endoscopic photography
Glucocorticoids
head positions
Humans
nose drops
Patient Satisfaction
Pharmaceutical Solutions
Posture
Rhinitis - drug therapy
Sinusitis - drug therapy
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Summary:An evaluation of the best head position for instillation of steroid nose drops Steroid nose drops are used frequently to treat rhinosinusitis and nasal polyposis. The middle meatal area is of key importance in the pathophysiology of these conditions. This study assesses which of three head positions commonly used to instil nose drops resulted in the highest coverage of this area. Discomfort levels were also studied using a visual analogue scale for each position. Five volunteers were studied in: (i) head back (HB); (ii) head forward and down (HFD); and (iii) lying head back (LHB) positions. Betamethasone nose drops, dyed with fluorescein, were instilled into each nostril and the distribution was studied endoscopically. The middle meatus area distribution was highest in the LHB position (55.51%), followed by HFD (31.55%) and HB (6.87%) positions. Comparison of distribution between HB and LHB (P = 0.002) and between HB and HFD (P = 0.045) was statistically significant. The HFD position was most uncomfortable (mean discomfort score 8.8) whereas the HB (2.4) and LHB (2.6) were similar. The LHB would, therefore, appear to be the most suitable position for instillation of steroid nose drops.
ISSN:0307-7772
1365-2273
DOI:10.1046/j.1365-2273.2002.00515.x