Benefits, pitfalls and risks of phytotherapy in clinical practice in otorhinolaryngology.
Abstract
OBJECTIVES:
To elucidate the benefits, pitfalls and risks of phytotherapy in the clinical practice of otorhinolaryngology.
MATERIAL AND METHODS:
The
PubMed and Cochrane databases were searched using the following
keywords: phytotherapy, phytomedicine, herbs, otology, rhinology,
laryngology, otitis, rhinitis, laryngitis and otorhinolaryngology.
Seventy-two articles (18 prospective randomized studies, 4 Cochrane
analyses, 4 meta-analysis and 15 reviews of the literature) devoted to
clinical studies were analyzed. Articles devoted to in vitro or animal
studies, biochemical analyses or case reports (including fewer than 10
patients) and articles dealing with honey, aromatherapy or minerals were
excluded.
RESULTS:
Per
os ginkgo biloba has no indications in tinnitus, presbycusis or anosmia
following viral rhinitis. Traditional Asian medicine has no proven
benefit in sudden deafness or laryngeal papillomatosis. Per os mistletoe
extracts associated to conventional treatment for head and neck
squamous cell carcinoma does not increase 5-year survival. Extracts of
various herbs, notably echinacea, eucalyptus, petasites hybridus,
pelargonium sidoides, rosemary, spirulina and thyme, show superiority
over placebo for rhinosinusitis and allergic rhinitis, as does gingko
biloba for selected vertigo. There have been encouraging preliminary
results for intratumoral injection of mistletoe in head and neck
carcinoma and acupoint herbal
patching for allergic rhinitis. Herb intake should be screened for in
case of certain unexplained symptoms such as epistaxis, headache or
dizziness, or signs suggesting allergy. Phytotherapy should be
interrupted ahead of surgery and/or chemotherapy.
CONCLUSION:
Scientific
proof of the benefit of phytotherapy in otorhinolaryngology remains to
be established but, given its widespread use and the reported data,
knowledge of this form of treatment needs to be developed.
Copyright © 2016 Elsevier Masson SAS. All rights reserved.
KEYWORDS:
Herbs; Otorhinolaryngology; Phytomedicine; Phytotherapy