Consensus document for prescription of nebulization in rhinology

ObjectivesThe French Society of ORL set up a work group to draw up a consensus document on the prescription of nebulization in rhinology. The document deals with the principles of and indications for rhinologic aerosol therapy.Materials and methodsThe work group's methodology followed the rules published by the French health authority (Haute Autorité de santé [HAS]) in January 2006: “Methodological foundations for drawing up professional guidelines by formalized consensus” (available on the HAS website at http://www.has-sante.fr). The method used is the short version (without editorial group) of the RAND/UCLA Appropriateness Method; the short version was chosen because this particular consensus conference was dealing with a very precise topic with very few experts in the field.ResultsSonic aerosol therapy with nasal plug is the preferred modality, delivering treatment into the middle meati. The group recommends that drugs with market authorization for use in bronchopulmonary pathology should be nebulized in two 10-minute sessions per day for at least seven days. Indications for rhinologic aerosol therapy are: purulent edematous rhinosinusitis, subacute rhinosinusitis (4–12 weeks’ evolution), exacerbations of chronic rhinosinusitis, and postoperative (>1 month) rhinosinus suppuration. Audiometric monitoring is required in iterative aminoside nebulization.ConclusionRhinologic aerosol therapy can be used in purulent edematous rhinosinusitis, subacute rhinosinusitis, exacerbations of chronic rhinosinusitis and postoperative rhinosinus suppuration. The rules for prescription contained in the present document optimize efficacy.