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Benefits, pitfalls and risks of phytotherapy in clinical practice in otorhinolaryngology.

  • 2017-04
  • European annals of otorhinolaryngology, head and neck diseases 134(2)
    • O Laccourreye
    • A Werner
    • L Laccourreye
    • P Bonfils

Study Design

Type
Review
Sample size
n = 10
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.

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.

Research Insights

  • Butterbur→Improved Rhinosinusitis Symptom

    Extracts of various herbs, notably echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis

    Effect
    Beneficial
    Effect size
    Small
  • Echinacea→Improved Rhinosinusitis Symptom

    Extracts of various herbs, notably echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis

    Effect
    Beneficial
    Effect size
    Small
  • Geranium→Improved Rhinosinusitis Symptom

    Extracts of various herbs, notably echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis

    Effect
    Beneficial
    Effect size
    Small
  • Ginkgo→Improved Anosmia

    Per os ginkgo biloba has no indications in ... anosmia following viral rhinitis

    Effect
    Neutral
    Effect size
    Small
  • Ginkgo→Improved Hearing Loss

    Per os ginkgo biloba has no indications in ... presbycusis

    Effect
    Neutral
    Effect size
    Small
  • Ginkgo→Improved Tinnitus

    Per os ginkgo biloba has no indications in tinnitus

    Effect
    Neutral
    Effect size
    Small
  • Ginkgo→Improved Vertigo

    gingko biloba for selected vertigo

    Effect
    Beneficial
    Effect size
    Small
  • Rosemary→Improved Rhinosinusitis Symptom

    Extracts of various herbs, notably echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis

    Effect
    Beneficial
    Effect size
    Small
  • Spirulina→Improved Rhinosinusitis Symptom

    Extracts of various herbs, notably echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis

    Effect
    Beneficial
    Effect size
    Small
  • Thyme→Improved Rhinosinusitis Symptom

    Extracts of various herbs, notably echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis

    Effect
    Beneficial
    Effect size
    Small

Adverse Events Reported

  • Ginkgo→Overall tolerability

    Per os ginkgo biloba has no indications in tinnitus, presbycusis or anosmia following viral rhinitis.

    Finding
    Reported
  • Ginkgo→allergic reaction

    Herb intake should be screened for in case of certain unexplained symptoms such as epistaxis, headache or dizziness, or signs suggesting allergy.

    Finding
    Reported
  • Ginkgo→dizziness

    Herb intake should be screened for in case of certain unexplained symptoms such as epistaxis, headache or dizziness, or signs suggesting allergy.

    Finding
    Reported
  • Ginkgo→epistaxis

    Herb intake should be screened for in case of certain unexplained symptoms such as epistaxis, headache or dizziness, or signs suggesting allergy.

    Finding
    Reported
  • Ginkgo→headache

    Herb intake should be screened for in case of certain unexplained symptoms such as epistaxis, headache or dizziness, or signs suggesting allergy.

    Finding
    Reported
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