Efficacy and Safety of Corticosteroid Treatments in Chronic Rhinos- inusitis Management: A Systematic Review

Chronic rhinosinusitis (CRS) is a prevalent inflammatory disorder of the nasal and paranasal sinus mu- cosa, affecting 5-15% of the global population. This systematic review evaluated the efficacy and safety of systemic, injectable, and intranasal corticosteroids (CS) for the treatment of CRS and its subtypes. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science, focusing on studies published between 2010 and 2023. Six studies were finally included in the analysis. Systemic CS, particularly oral CS, significantly improved nasal congestion, reduced nasal polyp size, and enhanced the quality of life in the short term. However, their long-term use is discouraged because of side effects, such as insomnia and gastrointestinal issues. Injectable CS offer longer symptom relief and potentially lower adrenal suppression risk than oral forms, but data are limited. Intranasal CS are preferred because of their safety and efficacy in long-term maintenance therapy, with newer formulations offering increased potency and reduced systemic absorption This review highlights the importance of tailoring CS treatment based on CRS subtype, severity, and patient-specific factors. Future research should focus on optimizing CS delivery methods and exploring novel therapies to enhance the long-term management of CRS, while minimizing adverse effects.