Men-dar Wu

Effects of Dexamethasone on Tissue Injury and Reconstruction in Ethanol/Steroid Injection Therapy for Allergic Rhinitis

Conventional therapies involving radiofrequency tissue ablation or laser cauterization for allergic rhinitis are accompanied by lesioning and restoration of the mucosa, which are important healing processes. The extent of these processes is difficult to control in these therapies, however, and often leads to mucosal erosion and severe pain for patients. To address this problem, we attempted to develop a new clinical treatment for allergic rhinitis that mitigates requisite mucosal damage through the injection of ethanol (E) containing a glucocorticoid into the inferior turbinate mucosa in taking advantage of the superior degeneration and coagulation capabilities of E in tissues [1,2]. We predicted that considerable technical skill would be required to inject ethanol into the nasal mucosa without spreading tissue damage to the mucosal surface. We overcame this technical problem by alleviating tissue damage as much as possible in the early treatment phase after the injection because injury is augmented by an inflammatory response characterized by neutrophil infiltration that accompanies tissue damage upon ethanol administration [3]. In doing so, we found that adding a glucocorticoid with potent anti-inflammatory activity alleviated tissue damage and by preserving the contractile effects of tissue itself, reduced the infiltration of inflammatory cells, especially neutrophils, into inflamed sites in a dose-dependent manner [3]. The clinical application of this E/steroid mixture as so-called submucosal E/steroid injection