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Effectiveness of Budesonide Nasal Instillation in a Vertex-to-floor Position

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
Navarat Vatcharayothin, Khon Kaen University Identifier:
First received: July 16, 2016
Last updated: August 18, 2016
Last verified: August 2016
o Chronic rhinosinusitis is one of the most common health issue affected American population. Surgery plays an important role in the patients who failed the medical treatment. The most difficult location to be operated endoscopically is the frontal sinus. Frontal sinus is also found to be one of the most common sinus for residual and recurrence after the operation. Intranasal steroid seems to be one of the most beneficent post-sinus surgery cares. The topical therapy can be delivered by many approaches. According to the standard clinical practice guideline and recommendations, intranasal corticosteroid spray is suggested. The technique proved to have greater distribution than standard intranasal spray is instillation of steroid nose drops. The head position for instillation of steroid nose drops proven to have a greater access to olfactory cleft and frontal area is Vertex-to-floor position.

Condition Intervention Phase
Chronic Frontal Rhinosinusitis
Vertex to Floor Position
Drug: Budesonide nasal instillation
Drug: Normal saline nasal instillation
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Effectiveness of Budesonide Nasal Instillation in a Vertex-to-floor Position in Chronic Rhinosinusitis Patients Underwent Endoscopic Frontal Sinus Surgery: a Randomized, Controlled Trial.

Resource links provided by NLM:

Further study details as provided by Khon Kaen University:

Primary Outcome Measures:
  • Total Sinonasal outcome test (SNOT) 20 score (validated Thai version) [ Time Frame: three months ]

Secondary Outcome Measures:
  • Video-recorded nasal endoscope scoring: Modified Lund-Mackay Endoscopy Score(MLMES) [ Time Frame: three months ]
  • Rhinological Sinonasal outcome test (SNOT) 20 score (validated Thai version) [ Time Frame: three months ]

Estimated Enrollment: 60
Study Start Date: November 2015
Estimated Study Completion Date: August 2017
Estimated Primary Completion Date: August 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Budesonide nasal instillation
budesonide(0.5mg/2ml) 1 respule plus normal saline solution 120ml instilled in vertex to floor position daily
Drug: Budesonide nasal instillation
Placebo Comparator: Normal saline nasal instillation
Normal saline solution instilled in vertex to floor position daily
Drug: Normal saline nasal instillation


Ages Eligible for Study:   12 Years and older   (Child, Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Chronic rhinosinusitis with frontal sinusitis patient
  • Age ≥12
  • Post-frontal sinus surgery with frontal sinus opening>3mm
  • Satisfactory surgical technique: adequate sinus osteal drainage and mucosal sparing technique

Exclusion Criteria:

  • Isolated frontal sinus surgery
  • History of previous head and neck radiation
  • Previous nasal or sinus operation
  • Clinically significant deviated nasal septum
  • History of paranasal sinus tumor
  • Known immunocompromised Host
  • History of budesonide allergy
  • Cannot provide full flexion of the neck (cannot perform vertex-to-floor position)
  • Post-randomization exclusion: Pathologic invasive fungal infection
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Please refer to this study by its identifier: NCT02862509

King Chulalongkorn Memorial Hospital
Bangkok, Thailand, 10330
Srinagarind Hospital
Khon Kaen, Thailand, 40002
Sponsors and Collaborators
Khon Kaen University
  More Information


Responsible Party: Navarat Vatcharayothin, Principal Investigator, Khon Kaen University Identifier: NCT02862509     History of Changes
Other Study ID Numbers: HE581299
Study First Received: July 16, 2016
Last Updated: August 18, 2016

Keywords provided by Khon Kaen University:
Post-frontal sinus operation chronic rhinosinusitis patients
Budesonide nasal instillation
Vertex to floor position

Additional relevant MeSH terms:
Paranasal Sinus Diseases
Nose Diseases
Respiratory Tract Diseases
Respiratory Tract Infections
Otorhinolaryngologic Diseases
Anti-Inflammatory Agents
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Hormones, Hormone Substitutes, and Hormone Antagonists processed this record on May 25, 2017