Formation of crusts and barks in the nose

Question

Hello,

I am colonized with MRSA and have the above titled problem since 8 years. Nasal showers do only relieve the symptoms.

Could the inhalation with the Pari Sinus bring relieve and is it paid by the insurance?

Many thanks

Answer

Hello,

In general in case of CF the same impairment of the chloride channels and of other regulatory mechanisms do exist at the mucosa of the upper airways and sinuses as in the lungs.

Therefore the actual approved options of therapies will achieve above all a relieve of the symptoms and their consequences but not a final solution of the problem. This is true for conservative as well as operative therapeutic options.
Basically, the nasal shower is up to now the standard in order to get rid of crusts and barks from the nasal mucosa, but there are also patients who profit from the vibrations via the nasal cornet.

The Pari Sinus nebulizer, with which vibrating aerosoles reach the sinuses (see Möller et al. 2010) has to be prescribed.

Recently, we were able to show, that problems with the nose and sinuses are significantly reduced in the group of patients, who inhaled DNAse via the Pari Sinus (see publication) and we can imagine, that the cheaper 6-7% Sodiumchloride solution can have a similar effect. At the moment we are performing a Germany-wide multicenter study about the nasal inhalation of 6% Sodiumchloride solution via the Pari Sinus with the support of the German Patient organization "Mukoviszidose e.V." and the Luxemborgian `Association Luxembourgeoise de Lutte contre la Mucoviscidose´.
Recent scientific literature recommendations in english:

Pulsating aerosols for drug delivery to the sinuses in healthy volunteers.
Möller W, Schuschnig U, Khadem Saba G, Meyer G, Junge-Hülsing B, Keller M, Häussinger K. Otolaryngol Head Neck Surg. 2010 Mar;142(3):382-8.

Management of chronic rhinosinusitis in CF.
Mainz JG, Koitschev A.
J Cyst Fibros. 2009 Jun;8 Suppl 1:S10-4.


Dr. Jochen G. Mainz

04.10.2010