Structural problems with the nose and sinuses may ultimately require surgical correction to cure them. This should be done only after more conservative measures have been tried and failed. Septal deviation, septal spurs, septal perforation, enlargement of the turbinates, and nasal/sinus polyps can lead to pooling of or overproduction of secretions, blockage of the normal pathways leading to chronic sinusitis, and chronic irritation. The surgery is performed by an ear-nose-throat doctor (otolaryngologist). Surgery can also enhance the delivery of nasal medications and rinses into the nasal cavities.
A second study assessed adrenal response to mometasone furoate nasal spray, 50 mcg (400 and 1600 mcg/day), prednisone (10 mg/day), and placebo, administered for 29 days in 48 male volunteers (21 to 40 years of age). The 24-hour plasma cortisol area under the curve (AUC 0-24 ), during and after an 8-hour Cortrosyn infusion and 24-hour urinary free cortisol levels were determined at baseline and after 29 days of treatment. No statistically significant differences in adrenal function were observed with mometasone furoate nasal spray, 50 mcg compared to placebo.