Optimizing Corticosteroid Sinonasal Irrigation Outcomes Through 3D Printing: A Randomized Pilot Clinical Trial

Abstract Objective Topical corticosteroid irrigation plays critical role in the management of chronic rhinosinusitis (CRS). Yet, its efficacy can be highly variable. We sought to determine if personalized, 3‐dimensional (3D)‐printed nasal models can optimize head positioning and irrigation parameters, therefore improving patient outcomes. Study Design Randomized, single‐blinded clinical trial. Setting Tertiary medical center from November 2021 to July 2023. Methods Sixty‐two patients with CRS were randomized into either control (CG), backfill (BG), or model (MG) groups; daily 2 mg mometasone irrigations were then performed for 2 months with either standard head‐forward and natural side‐tilt position (CG), a head tilt of 90° to the side with fluid entering the lower nostril (BG), or in an optimized position as determined by a patient‐specific 3D printed irrigation model (MG), respectively. Results A total of 36 patients completed the trial (CG: N = 14/23; BG N = 11/23, MG: N = 11/16). Significant posttreatment improvement in Lund‐Mackay (LM) scoring was only observed in the MG (−3.73, 95% confidence interval = −5.71, −1.75; P