Corticosteroids, sometimes called simply “steroids”, are useful medications that treat all kinds of inflammation. (Note these “corticosteroids” are NOT the same as the “anabolic steroids” that some athletes take to get stronger) Inflammation can occur in all parts of the body and range from an annoying case of poison ivy to a life-threatening response to a serious infection.
Steroids come in many forms, like intravenous (delivered through the blood), oral, inhaled, and topical (including creams, ointments, and sprays). They can have undesirable side effects, and in most cases should be used only upon the advice of a medical professional, but in the right situations can literally be life-savers!
Inflammation of the tissues of the nose and sinuses is very common and can have many causes, including viruses (such as the common cold), allergies, environmental irritants, and bacterial infections. Patients may report troubling symptoms including congestion, runny nose, loss of smell, sneezing, and facial pressure/pain. This inflammation within the nose and sinuses can sometimes last for a long time – when it persists for more than 12 weeks doctors call this “chronic rhinosinusitis”.
Just like anywhere in the body, corticosteroids can be very helpful for controlling inflammation in the nose and sinuses. For severe inflammation, your doctor may prescribe a short course of oral steroids (such as prednisone or solu-medrol). Taking steroids by mouth can often help you feel better quickly, but should be used sparingly because of possible side effects. A safer way to treat the inflammation long-term is to use these medications directly in the nose, typically through daily use of a topical spray such as fluticasone or mometasone.
In many cases, using a nasal steroid spray is a safe, effective way to control symptoms of sinonasal inflammation due to problems like allergies and chronic sinusitis. For some patients, however, these sprays don’t provide enough medicine to the inflamed tissues, and symptoms continue. Studies have shown that most of the nasal spray is left in the front part of the nose, even though inflammation may be in deeper areas. In these cases, otolaryngologists may recommend using a different method to deliver steroids into the nose and sinuses. This may involve putting a liquid steroid medication into a high-volume saline rinse or dripping the solution directly into the nose. Alternatively, special nebulizer machines can be used to create a mist containing medication. In a few situations, doctors may recommend placing a temporary stent into the sinus cavity to secret potent steroids exactly where they are needed most.