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To assess the effects of different types of intranasal steroids in people with chronic rhinosinusitis, we performed a retrospective cohort case/control study in patients who were on long‐term treatment with intranasal steroid therapy for rhinosinusitis (n = 565). A total of 382 patients were randomly enrolled in the study; the mean age at entry was 38 years (range, 15–67 years). All patients were treated with intranasal steroid for rhinosinusitis and received long‐term treatment for rhinosinusitis up to seven years. We included information on the use of oral and transdermal agents to treat each of the three categories of rhinosinusitis: generalized rhinosinusitis (GRS), focal rhinosinusitis (FCR), and allergic rhinosinusitis (ARI). In addition to information on the type and amount of steroid therapy used in each treatment category, we extracted information on the mean dose, number of days' dosage, and the duration of therapy to determine the dose–response relationship of short‐term steroid treatment to the severity of rhinosinusitis. In a subgroup analysis, we investigated the dose–response relationship between intranasal steroid therapy and the proportion of rhinosinusitis classified as having an inflammatory response. The clinical features of intranasal steroid induced rhinosinusitis have been described elsewhere.10 Briefly, intranasal steroid is often used as a treatment for chronic rhinosinusitis in children and adolescents with chronic rhinosinusitis. In addition to the need to dose titrate steroids for the relief of rhinosinusitis, the optimal duration of intranasal steroid treatment is not clearly defined.14,15 However, a recent systematic review and metaanalysis of clinical studies concluded that a dose–response relationship existed with daily intranasal or subcutaneous oral doses of 2 mg or more of testosterone and an oral dosage of 10–30 mg of steroid.16 Further studies evaluating the use of intranasal steroids for chronic rhinosinusitis must examine long‐term efficacy. Preliminary evidence of the short‐term effects of intranasal treatment for rhinosinusitis and its relation to the severity of the disease is encouraging. It has been shown that intranasal steroids are effective in short‐term treatment of pediatric chronic rhinosinusitis.22,23 The duration of treatment in the current study was seven years, which corresponds to approximately 10 years in the treatment of adults with chronic rhinosinusitis. In addition, intranasal steroids have Similar articles: