| Effect of Exhalation Delivery System With Fluticasone for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis |
Min Su Kim1
, Gulnaz Stybayeva2, Yun Jin Kang1
, Se Hwan Hwang3
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1Department of Otolaryngology-Head and Neck Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
3Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea |
| 만성 비부비동염에 대한 플루티카손 흡입 전달 시스템의 효과: 체계적 문헌 고찰 및 메타 분석 |
| 김민수1
, Gulnaz Stybayeva2, 강윤진1
, 황세환3
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1가톨릭대학교 의과대학 여의도성모병원 이비인후과학교실
2메이오 클리닉 생리학 및 생의학 공학과
3가톨릭대학교 의과대학 부천성모병원 이비인후과학교실 |
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Received: 20 February 2026; Revised: March 25, 2026 Accepted: 31 March 2026. Published online: 15 May 2026. |
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| ABSTRACT |
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An exhalation delivery system for fluticasone (EDS-FLU) is designed to deposit drug into sinonasal regions above the inferior turbinate, particularly sinus drainage pathways not reached by standard nasal steroid sprays. We evaluated the efficacy and safety of EDS-FLU for chronic rhinosinusitis (CRS). We reviewed four independent randomized controlled trials derived from three published articles identified through searches of PubMed, Embase, SCOPUS, Google Scholar, Web of Science, and the Cochrane Library up to April 2024. Outcomes included 22-item Sinonasal Outcome Test (SNOT-22) scores, nasal symptom scores, nasal polyp scores, patient global impression of change (PGIC), responder and surgical indication rates, and adverse events. Compared with EDS-placebo, EDS-FLU produced greater reductions in nasal polyp scores and SNOT-22 scores over 6 months. At 3 months, nasal congestion, facial pain, rhinorrhea, and olfactory dysfunction improved more with EDS-FLU, and PGIC responder and complete response rates were higher at 3 and 6 months. EDS-FLU reduced surgical indication and increased overall responder rates at 3 months but not at 6 months. Epistaxis and nasal septal erosion or ulceration occurred more frequently with EDS-FLU, whereas rates of headache, nasal congestion, nasopharyngitis, and upper respiratory infection were similar between groups. EDS-FLU provides clinically meaningful improvements in subjective and objective outcomes in CRS but is associated with an increased risk of local nasal adverse events, warranting individualized risk-benefit assessment. |
| Keywords:
Chronic rhinosinusitisㆍ Exhalation delivery systemㆍ Fluticasone propionateㆍ Intranasal corticosteroidsㆍ Nasal polyps |
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