Dynamic telethermography to evaluate betamethasone action in the treatment of acute sinusitis - Preliminary study

OBJECTIVES: Heat emitted during the process of inflammation can be visualized by means of dynamic telethermography (DDT). In the case of sinusitis, it is possible to verify the efficacy of an anti-inflammatory treatment such as betamethasone. PATIENTS AND METHODS: Ten adult ambulatory patients with sinusitis were treated with 2 tablets of betamethasone (Celestene) 2 mg daily for 10 days without concomitant medications. DDT images were obtained on day 0, day 2, day 3, day 5 and day 10. A color chart indicated differences in temperature according to the selected sensitivity. Computer analysis of the images was then obtained. Clinical assessment of symptoms and tolerance were recorded at the same time-points as the DM images. RESULTS: The effect of treatment was beneficial in all patients since cure of sinusitis was achieved in 5, with marked improvement in 4 others and fair improvement in 1. Pain was significantly reduced on day 10 compared with day 0 (Friedman's test p < 0.0001). There was a simultaneous reduction of sinusitis associated signs: rhinorrhea, lacrimation, photophobia and cutaneous hyperesthesia as well as of general signs. On the DDT images, right-sinus to right-side and left-sinus to left-side ratios both showed a significant decrease between day 0 and day 10 from 41.00 +/- 14.07 to 7.90 +/- 7.22 (ANOVA p < 0.0001) and from 30.70 +/- 5.20 +/- 6.49 (ANOVA p < 0.0001) respectively. DISCUSSION: Whereas in animal pharmacology inflammation can be evaluated by any number of objective methods, only a very few are applicable to clinical situations. Powerful computer image analysis may prove useful in establishing nature and severity based inflammation reduction standards. CONCLUSION: These preliminary findings demonstrated that in most cases single agent therapy provides adequate and rapid control of clinical and thermographic signs of acute sinusitis. Computer analysis corraborates clinical findings and thermogram interpretations.