Consensus document for prescription of nebulization in rhinology

Objectives: The 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 methods: The work group's methodology followed the rules published by the French health authority (Haute Autorite de sante [HAS]) in January 2006: "Methodological foundations for drawing up professional guidelines by formalized consensus" (available on the HAS website at hep://www.has-santeir). 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. Results: Sonic 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 rhino sinusitis, and postoperative (>1 month) rhino sinus suppuration. Audiometric monitoring is required in iterative aminoside nebulization. Conclusion: Rhinologic 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. (C) 2014 Elsevier Masson SAS. All rights reserved.