Evaluation of the clinical effects of isotretinoin on chronic rhinosinusitis

Abstract

Objectives: This study aims to evaluate the clinical effects of isotretinoin (13-cis-retinoic acid), a derivative of retinoic acid, on the clinical features of chronic rhinosinusitis. Patients and Methods:The study group included 25 chronic rhinosinusitis patients (16 females, 9 males; mean age 25.2±6.8 years; range 15 to 25 years) who were on isotretinoin for acne treatment, while the control group consisted of 25 chronic rhinosinusitis patients (15 females, 10 males; mean age 25.2±6.8 years; range 15 to 25 years) who were not on isotretinoin treatment. The patients' symptom scores in visual analog scale (VAS), Lanza and Kennedy nasal endoscopic scores and Newman computed tomography (CT) scores were obtained in order to evaluate the their symptom, examination and radiological findings. These patients' symptom and examination results were evaluated first day, week two and at months 3-5 and 6-10. Paranasal sinus CT results were studied first day and at months 6-10. Results:In the group of patients being administered isotretinoin, no significant change in the mean symptom and examination scores was detected during the acute phase (week 2), while there was a significant regression in the longterm (months 3-5 and 6-10). There was a significant regression in the mean CT score after isotretinoin therapy. In the control group no significant change was seen in any of the scores. The number of acute sinusitis attacks were significantly lower in the isotretinoin group than in the control group. No significant difference was found between the two groups in terms of the duration of the healing period of acute sinusitis attacks. Conclusion:We conclude that the long-term administration of isotretinoin has positive effects on the clinical results of chronic rhinosinusitis.

Epidemiology and extracutaneous comorbidities of severe acne in adolescence: a U.S. population-based study

“…25 A study of 25 Turkish patients with and 25 without chronic rhinosinusitis found that isotretinoin resulted in long-term improvement in symptoms and computed tomography score and fewer acute flares. 26 Together, these studies suggest a potential role of P. acnes in the pathogenesis of sinopulmonary disease. However, it is possible that the improvement was related to the innate anti-inflammatory properties of isotretinoin.…”

“…A previous bacteriological study of 48 patients with chronic maxillary sinusitis found colonization of the sinuses with P. acnes and other anaerobes, and proposed that these bacteria may play a role in the pathogenesis of sinusitis . A study of 25 Turkish patients with and 25 without chronic rhinosinusitis found that isotretinoin resulted in long‐term improvement in symptoms and computed tomography score and fewer acute flares . Together, these studies suggest a potential role of P. acnes in the pathogenesis of sinopulmonary disease.…”

Evaluation of Nasal Mucociliary Clearance, Nasal Obstruction Symptom Evaluation, and Epistaxis Severity Score in Isotretinoin Treatment

“…2 The reason of this is that in literature, the nasal dryness is considered to be the underlying mechanism causing the decreased MCT (which is the objective finding of isotretinoin use) and epistaxis (which is the subjective finding of isotretinoin use). 2,9,10,13,14 In our study, epistaxis was evaluated with ESS questionnaire. 15 Five (4.9%) patients had a history of epistaxis in the last 6 months before the treatment, and this number increased to 60 (59.4%) when the treatment was completed (P ¼ .021).…”

“…2 The reason of this is that in literature, the nasal dryness is considered to be the underlying mechanism causing the decreased MCT (which is the objective finding of isotretinoin use) and epistaxis (which is the subjective finding of isotretinoin use). 2,9,10,13,14…”