Effect of steroids for nasal polyposis surgery: A placebo‐controlled, randomized, double‐blind study

Ecevit, Mustafa Cenk; Erdağ, Taner Kemal; Doğan, Ersoy; Sütay, Semih

doi:10.1002/lary.25352

Cited by 51 publications

(38 citation statements)

References 29 publications

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“…The mean visibility scores of the surgical field in the PSL 3 and PSL 7 groups were 2.7 ± 0.8 and 2.5 ± 0.6, respectively. This result was consistent with previous findings obtained using the same scale (2.4 vs. 3.3 in the with or without PSL groups [18], 2.4 vs. 3.4 in the PSL or placebo groups [10], respectively). Hence, our PSL treatment protocol appeared to be beneficial for surgical visibility.…”

Section: Discussionsupporting

confidence: 83%

“…The complete removal of ethmoid cells, so-called “full-house ESS,” is needed because incomplete surgery including functional ESS is one of the important factors contributing to the recurrence of CRS [8]. The good visualization of surgical fields and reductions in mucosal edema associated with the preoperative corticosteroids contributed to successful surgery especially in ECRS, and higher postoperative recurrence-free rates [9, 10]. Furthermore, the high complication rate of bronchial asthma is one of the clinical characteristics of ECRS [11], and the preoperative use of corticosteroids is recommended to prevent aggravation of the lower respiratory tract [12].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Preoperative Systemic Corticosteroids on the Histology and Diagnosis of Eosinophilic Chronic Rhinosinusitis

Akiyama

Makihara²,

Uraguchi³

et al. 2019

Int Arch Allergy Immunol

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Background: The histological changes corticosteroids induce in nasal polyps, and whether these changes have an impact on the diagnosis of eosinophilic chronic rhinosinusitis (ECRS), currently remain unclear. Objectives: A prospective controlled multicenter trial was conducted to evaluate the efficacy of the low-dose and short-term oral prednisolone (oPSL) treatment for tissue eosinophil infiltrations in ECRS. Methods: Subjects with ECRS diagnosed by previous biopsies received a low dose of oPSL for 3 days (PSL 3) or 7 days (PSL 7) before surgery. Changes in the tissue eosinophil count after these treatments were evaluated. Furthermore, the percent change of tissue eosinophil count from baseline and its impact on the diagnosis defined by the JESREC study were examined. Results: There were 23 and 21 subjects in the PSL 3 and PSL 7 groups, respectively. Polyp scores, clinical symptom scores, and the proportion of blood eosinophils significantly decreased after the treatment, and no significant differences were observed between the groups. The entire tissue eosinophil count tended to be slightly decreased in both groups without reaching a statistically significant value. The median percent change of tissue eosinophil count from baseline was 83.6%, and only the posttreatment proportion of blood eosinophil showed a mild correlation with it. Seven out of 44 nasal polyp specimens collected from the superficial part of the middle meatus showed < 70 eosinophils/high-power field; therefore, the false negative rate was 15.9%, but decreased to 11.4% when other parts were included in the histological evaluation. Conclusions: Low-dose and short-term oPSL did not appear to markedly affect the tissue eosinophil count in ECRS patients; however, the potential for misdiagnoses due to the effects of oPSL cannot be rejected. The diagnosis of ECRS prior to the administration of corticosteroids or tissue evaluations using multiple tissue parts is desirable.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Impact of Preoperative Systemic Corticosteroids on the Histology and Diagnosis of Eosinophilic Chronic Rhinosinusitis

Akiyama

Makihara²,

Uraguchi³

et al. 2019

Int Arch Allergy Immunol

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“…It is known that steroid treatment improves PNIF rates in CRS. For example, in 2012 Ecevit et al . reported significant improvement in monorhinal PNIF following administration of oral prednisolone in patients with CRSwNP.…”

Section: Discussionmentioning

confidence: 99%

Peak nasal inspiratory flow correlates with quality of life in functional endoscopic sinus surgery

Whitcroft

Andrews

Randhawa

2017

Clinical Otolaryngology

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“…In contrast to CRS without nasal polyps, the positive effect of systemic steroids for the treatment of CRS with nasal polyps has, in the meantime, been clearly confirmed by several RCTs [156], [157], [158], [159], [160]. The quality of life of the patients and the nasal obstruction is improved and the size of the polyps reduced.…”

Section: Types and Therapies Of Rhinosinusitismentioning

confidence: 96%

Evidence and evidence gaps in therapies of nasal obstruction and rhinosinusitis

Rotter¹

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc06

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Effect of steroids for nasal polyposis surgery: A placebo‐controlled, randomized, double‐blind study

Abstract: 1b.

Cited by 51 publications

References 29 publications

Impact of Preoperative Systemic Corticosteroids on the Histology and Diagnosis of Eosinophilic Chronic Rhinosinusitis

Impact of Preoperative Systemic Corticosteroids on the Histology and Diagnosis of Eosinophilic Chronic Rhinosinusitis

Peak nasal inspiratory flow correlates with quality of life in functional endoscopic sinus surgery

Evidence and evidence gaps in therapies of nasal obstruction and rhinosinusitis

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