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Intranasal steroids and septum perforation--an overlooked complication? A description of the course of events and a discussion of the causes

Cervin, Anders LU and Andersson, M (1998) In Rhinology 36(3). p.128-132
Abstract
The use of intranasal steroids for the treatment of allergic and vasomotor rhinitis has doubled during the past 5 years. The number of reported cases of nasal septum perforation has increased correspondingly. The mechanism behind this is unknown, and steroid-induced septum perforation is rarely described in the literature. In order to describe the course of events and to form an idea of the extent of the problem, we have reviewed the cases reported at our clinic and compiled reports on side-effects from the Swedish Medical Products Agency. In our department we found 32 patients with septum perforation (21 women and 11 men). The most common risk factor for septum perforation was steroid treatment, 11 cases (10 women, 1 man, average age 33... (More)
The use of intranasal steroids for the treatment of allergic and vasomotor rhinitis has doubled during the past 5 years. The number of reported cases of nasal septum perforation has increased correspondingly. The mechanism behind this is unknown, and steroid-induced septum perforation is rarely described in the literature. In order to describe the course of events and to form an idea of the extent of the problem, we have reviewed the cases reported at our clinic and compiled reports on side-effects from the Swedish Medical Products Agency. In our department we found 32 patients with septum perforation (21 women and 11 men). The most common risk factor for septum perforation was steroid treatment, 11 cases (10 women, 1 man, average age 33 years, range 19-49 years). The information obtained from the Swedish Medical Products Agency showed that 38 cases of steroid induced septum perforation had been reported during the past 10 years. The number of side-effects per million Defined Daily Dose (DDD) was averaged to 0.21. The risk of perforation is greatest during the first 12 months of treatment and the majority of cases involves young women. We conclude that septum perforation due to nasal sprays are underreported in Sweden and that perforations are most likely to appear in young females during their first months of medication. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Rhinology
volume
36
issue
3
pages
128 - 132
publisher
International Rhinologic Society
external identifiers
  • pmid:9830677
  • scopus:0031771958
ISSN
0300-0729
language
English
LU publication?
yes
id
872b988b-7d31-44b3-add8-c720e7919933 (old id 1113027)
date added to LUP
2008-07-14 10:44:17
date last changed
2017-08-13 04:30:25
@article{872b988b-7d31-44b3-add8-c720e7919933,
  abstract     = {The use of intranasal steroids for the treatment of allergic and vasomotor rhinitis has doubled during the past 5 years. The number of reported cases of nasal septum perforation has increased correspondingly. The mechanism behind this is unknown, and steroid-induced septum perforation is rarely described in the literature. In order to describe the course of events and to form an idea of the extent of the problem, we have reviewed the cases reported at our clinic and compiled reports on side-effects from the Swedish Medical Products Agency. In our department we found 32 patients with septum perforation (21 women and 11 men). The most common risk factor for septum perforation was steroid treatment, 11 cases (10 women, 1 man, average age 33 years, range 19-49 years). The information obtained from the Swedish Medical Products Agency showed that 38 cases of steroid induced septum perforation had been reported during the past 10 years. The number of side-effects per million Defined Daily Dose (DDD) was averaged to 0.21. The risk of perforation is greatest during the first 12 months of treatment and the majority of cases involves young women. We conclude that septum perforation due to nasal sprays are underreported in Sweden and that perforations are most likely to appear in young females during their first months of medication.},
  author       = {Cervin, Anders and Andersson, M},
  issn         = {0300-0729},
  language     = {eng},
  number       = {3},
  pages        = {128--132},
  publisher    = {International Rhinologic Society},
  series       = {Rhinology},
  title        = {Intranasal steroids and septum perforation--an overlooked complication? A description of the course of events and a discussion of the causes},
  volume       = {36},
  year         = {1998},
}