Submucosal injections of hydrocortisone for allergic rhinitis and rhinitis medicamentosa.

THE following is ajsummary of the literature on this subject. Wall and Shure (Los Angeles) 1952, treated five cases of polypi by subjnucous injection of the turbinates. The turbinates shrank up and made removal of the polypi easier. Sidi and Tardiff in Paris, 1955, injected the anterior third of the inferior turbinates and also the septum. W'alter Owen, 1956, injected Hydrocortisone into the substances of polyps. The injections were made on three occasions at weekly intervals. There was marked reduction in the size of the polyps. E. Clerici, L. Teseo, G. Massara, report in the Archives of Italian Otology 1955, the local use of cortisone and hydrocortisone by endonasal submucous injections in various clinical forms of vasomotor rhinopathies. Eighty-three patients have been treated, twenty of them suffering from hay fever and sixty-three from vaso-rhinitis. Only slight improvements have been obtained in cases of hay fever. In vasomotor rhinitis 60 per cent, of favourable results have been observed with Cortisone and 80 per cent, with hydrocortisone. The following is ajreport on sixty-two cases treated at the Bolton Royal Infirmary since 1958: Technique. The solution used is a_2-5 per cent, sterile aqueous solution of Prednisolone (Roussell) made up in 5 ml. vials containing 125 mg. of Prednisolone and used usually for intra or peri-articular injection. A 25 gauge 3J in. needle is inserted into the anterior end of the inferior turbinate and slid along submucosally for about half its length. Extreme care is required not to perforate the mucosa as this results in loss of some of the solution. The injection is made slowly and the turbinate will be seen to swell and turn pale in colour. The needle is slowly withdrawn injecting at the same time. It is advisable to wait for a few moments before withdrawing the needle completely in order to avoid loss of solution. The usual dose has been_2 cc. into_e;ach^inferior turbinate. The injection can also be made into the middle turbinate and the septum.