Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May;172(5):1502-1511.
doi: 10.1002/ohn.1147. Epub 2025 Feb 3.

Nasal Corticosteroid Delivery Methods in Chronic Rhinosinusitis With Polyps: A Systematic Review

Robert E Gurevich  1 , Ajibola B Bakare  2 , Dylan A Levy  1 , Edward D McCoul  1   3
Affiliations

Nasal Corticosteroid Delivery Methods in Chronic Rhinosinusitis With Polyps: A Systematic Review

Robert E Gurevich et al. Otolaryngol Head Neck Surg. 2025 May.

Abstract

Objective: This systematic review evaluates and compares the efficacy and safety of different intranasal corticosteroid delivery methods for treating chronic rhinosinusitis with nasal polyps (CRSwNP).

Data sources: Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Web of Science were systematically searched from January 1, 1980 to January 9, 2024.

Review methods: Two independent reviewers searched 4 databases for English-language, prospective randomized controlled trials (RCT), comparing different delivery methods of corticosteroids for the treatment of CRSwNP. Studies were excluded for specific reasons (wrong comparisons, wrong intervention, wrong patient population, and wrong route of administration).

Results: The data search identified 2282 studies. After removing duplicates, 1503 studies were screened by title and abstract, with 1479 excluded for not meeting criteria. Eighteen full-text articles were assessed for eligibility, and 5 RCTs were included in the review. Both short- and long-term treatments with nebulizer, aerosol spray, and nasal drop methods demonstrated similar efficacy to oral corticosteroids (OCS) but with a better safety profile. Long-term use of aqueous sprays showed clinical improvement but was less effective than other non-aqueous delivery methods.

Conclusion: Non-aqueous delivery methods, including nebulizers, aerosol sprays, and nasal drops offer a safe alternative to OCS without systemic side effects. Patients using aqueous formulations should be advised on the importance of long-term adherence to achieve symptom improvement.

Keywords: aerosol; aqueous; chronic rhinosinusitis; intranasal corticosteroids; nasal drops; nebulizer; oral corticosteroids.

PubMed Disclaimer

References

    1. Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinol J. 2012;50:1‐12.
    1. Chong LY, Head K, Hopkins C, Philpott C, Burton MJ, Schilder AG. Different types of intranasal steroids for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016;4:CD011993.
    1. Fokkens WJ. EPOS2020: A major step forward. Rhinol J. 2020;58:1.
    1. Larsen PL, Tos M. Origin of nasal polyps: an endoscopic autopsy study. Laryngoscope. 2004;114:710‐719.
    1. Rezaeian A, Kargoshaei A, Rastegar Z. A comparison of beclomethasone aqueous spray and aerosol delivery system in nasal polyps: a randomized control trial. Adv Biomed Res. 2021;10:51.

Publication types

Substances

LinkOut - more resources