Accepted for presentation at the American Rhinologic Society at the Combined Otolaryngology Spring Meetings April 27 - 28, 2017, San Diego, California

Case Series of Probiotic Sinus Irrigations in Patients with Refractory Chronic Rhinosinusitis

Omar G. Ahmed, Michael Yim, Andrew Victores, Sarah Gitomer

Mas Takashima

Introduction

Refractory chronic rhinosinusitis (RCRS) affects 450,000 Americans despite endoscopic sinus surgery and maximal medical therapy. One of the prevailing hypothesis for the underlying cause is an altered microbiome with a higher proportion of pathogenic bacteria and a reduction in protective bacteria. Although probiotics confer many health benefits in the GI tract, their use in the sinuses through irrigations has never been investigated in human subjects.

Methods

Select patients with RCRS seen at an academic rhinology clinic were given probiotic sinus irrigations and followed regularly for improvement. A retrospective case series was conducted of patients from June 2013 to September 2016 who used probiotic sinus irrigations.

Results

A total of 30 patients were included in our case series with a mean age of 57 and an average follow up time of 290 days. Each patient had an average of 2 endoscopic sinus surgeries prior to beginning treatment. 0% of patients reported any major complications including intracranial or orbital infections. 63% (19/30) of patients reported a subjective improvement after starting treatment and 0% patients endorsed worsening symptoms. 33% (10/30) of patients had improved sinonasal endoscopic findings.

Conclusion

Probiotic sinus irrigations can be safely used in immunocompetent patients. In patients with RCRS, probiotic sinus irrigations may improve overall subjective symptoms. This study warrants the need for future prospective randomized placebo controlled trials.