The Effect of EDS-FLU on Objective and Patient-Reported Subjective Outcomes for Patients with Chronic Rhinosinusitis with Nasal Polyps.

Background: Exhalation delivery system with fluticasone (EDS-FLU) delivers medication high and deep in the nasal passages and has been shown to reduce nasal polyp (NP) grade, an objective measure of efficacy, and to yield clinically meaningful improvements on subjective measures of symptoms in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

Objectives: To better characterize EDS-FLU treatment, we analyzed responder rates for four outcome measures used in the EDS-FLU pivotal trials, in the overall study population as well as in subgroups of patients with or without prior sinus surgery or prior use of a standard intranasal corticosteroid spray (INS).

Methods: Data were pooled from two randomized, 24-week (16-week, double-blind + 8-week, open-label), placebo-controlled studies (NAVIGATE I and II).

What do we know about rhinogenic headache? The otolaryngologist’s challenge.

Sinus headache is a common presenting complaint in the otolaryngology office. Although most patients with this presentation are found to have migraine headache, many do not, and others fail therapy. This review focuses on the current understanding of nonneoplastic rhinogenic headache: headaches that are caused or exacerbated by nasal or paranasal sinus disease or anatomy.

Migraine and allergy: a review and clinical update.

Migraine and allergy are both common diseases. Many patients suffer from both, and the vast majority of patients with "sinus headache" complaints are found to have migraine, making migraine identification important to allergists. This review addresses the possibility that allergy and migraine are comorbid conditions, focusing on epidemiology, shared biochemical pathways, and underlying mechanisms.

Allergy and migraine: is there a connection?

Purpose Of Review: In the last 10 years, otolaryngologists and allergists have become increasingly aware of migraine headaches in their practices. This is partially due to a better understanding of the high incidence of migraine and a realization that the majority of patients presenting as 'sinus headache' are actually suffering from migraine headaches. Considering that the incidence of migraine is approximately 20% in women and 6% in men and that 10-30% of people have allergies (US Department of Health and Human Services.

Sinus CT scan findings in "sinus headache" migraineurs.

Objective: To evaluate the sinus CT scan findings in "sinus headache" migraineurs, and to compare the findings to nonmigraine "sinus headache" patients.

Background: The majority of patients presenting with "sinus headache" satisfy the International Headache Society (IHS) criteria for migraine headache. Few studies have correlated the rhinologic complaints and computed tomography (CT) findings in these patients.

Sinus headache, migraine, and the otolaryngologist.

"Sinus headache" is a common complaint in the otolaryngology office. Recent literature has shown that the majority of patients with this complaint satisfy the diagnostic criteria for migraine. This review article presents an overview of the sinus headache literature, with emphasis on the incidence, identification, and treatment of migraine headache for the otolaryngologist.

Are nasal steroids safe?

Nasal steroids have emerged as an integral part of rhinitis management. Most studies have shown no evidence of significant hypothalamic-pituitary-adrenal axis suppression from nasal steroid use, at least based on dynamic testing. Bone mineral density loss, glaucoma, and cataract formation are risks associated with systemic steroids, but reports with nasal steroid use are few.