Fluticasone propionate aqueous nasal spray does not influence the recurrence rate of chronic rhinosinusitis and nasal polyps 1 year after functional endoscopic sinus surgery

Abstract

This placebo-controlled study does not show that treatment with FPANS up to 1 year after FESS had a positive effect compared with placebo.

The use of Postoperative Topical Corticosteroids in Chronic Rhinosinusitis with Nasal Polyps: A Systematic Review and Meta-Analysis

“…All studies showed a significant benefit from INCS therapy compared with placebo, with the exception of three that did not find a statistically significant difference. 5,17,21 Dijkstra et al, 17 had a high withdrawal rate (64-70%) that may explain the lack of a significant difference. Rotenberg et al 21 published a high-quality study that found no effect from budesonide treatment in comparison with placebo in Samter's triad patients.…”

“…Fifteen percent (n ϭ 274, 2/13) of studies were at high risk of incomplete outcome data with an attrition rate of 38% 15 and up to 70%. 17 Overall reporting bias assessment was considered as low risk (85%). Just 15% (n ϭ 270; 3/13 [18][19][20] ) of included studies were at high risk of selective reporting.…”

“…24 One cohort study (n ϭ 32) 18 reported normal ACTH levels measured before and 1 hour after removal of corticosteroid-soaked packing gauze. 18 The reported adverse events from the included studies were blood-stained mucus, [22][23][24][25] mild epistaxis, 15,17,19 and nasal dryness. 22,23,26 …”

Sinus Surgery and Delivery Method Influence the Effectiveness of Topical Corticosteroids for Chronic Rhinosinusitis: Systematic Review and Meta-Analysis

“…40 Three trials used a direct sinus delivery technique whereby the drug was instilled directly into the sinus through a sinusotomy tube in one study, 39 intrasinus lavage in one study, 63 and postoperative nasal irrigation in one study. 64 Thirty trials delivered the topical steroid via a nasal spray, 17 …”

The Effectiveness of Budesonide Nasal Irrigation After Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Asthma

“…The literature contains a number of different findings concerning the use of nasal steroid spray after ESS. Dijkstra et al [14] used a doubleblinded randomized trial to assess the use of fluticasone propionate in reducing polyposis recurrence after ESS. The conclusion of the study was that the steroid did not have any beneficial effect on disease recurrence.…”