Post‐operative corticosteroid irrigation for chronic rhinosinusitis after endoscopic sinus surgery: A meta‐analysis

Yoon, Hyong Seo; Lee, Ho Seok; Kim, In Hye; Hwang, Se Hwan

doi:10.1111/coa.13015

Cited by 25 publications

(27 citation statements)

References 24 publications

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“…Topical steroid sprays and steroid nasal rinses are also known to be more effective after endoscopic sinus surgery [45–47]. For moderate symptoms, oral corticosteroids are also indicated for the treatment of CRSwNP and have been shown in randomized, placebo-controlled trials to decreased nasal symptoms, and polyp size when taken in moderate doses [48].…”

Section: Medical Treatment Optionsmentioning

confidence: 99%

“…Topical intranasal corticosteroids continue to be the mainstay of medical treatment CRSwNP with evidence demonstrating that it is safe and effective for improving symptoms, decreasing polyp size, and slowing polyp recurrence. Topical steroid sprays and steroid nasal rinses are also known to be more effective after endoscopic sinus surgery [45–47]. For moderate symptoms, oral corticosteroids are also indicated for the treatment of CRSwNP and have been shown in randomized, placebo-controlled trials to decreased nasal symptoms, and polyp size when taken in moderate doses [48].…”

Section: Medical Treatment Optionsmentioning

confidence: 99%

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The Role of Staphylococcus aureus in Patients with Chronic Sinusitis and Nasal Polyposis

Vickery

Ramakrishnan²,

Suh

2019

Curr Allergy Asthma Rep

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Purpose of Review Staphylococcus aureus (S. aureus) is correlated with the development of persistent severe inflammatory disease of the upper airway including chronic rhinosinusitis with nasal polyps (CRSwNP). The presence of S. aureus is associated with atopic disease including allergic rhinitis and atopic dermatitis and is associated with poor outcomes. Recent Findings Several different strains of S. aureus generate different toxins and gene products that can account for organism pathogenicity. S. aureus bacteria and its antigens shape the bacterial and fungal microbiome and the mucosal niche which generates host responses that can account for inflammation. The multiple disease phenotypes and molecular endotypes seen in CRSwNP can be characterized by T-helper cell environment within the inflammatory milieu, the presence of epithelial barrier dysfunction, aberrant eicosanoid metabolism, poor wound healing, and dysfunctional host-bacteria interactions which lead to recalcitrant disease and worse surgical outcomes. Summary Understanding the pathomechanisms that S. aureus utilizes to promote nasal polyp formation, prolonged tissue inflammation, and bacterial dysbiosis are essential in our efforts to identify new therapeutic approaches to resolve this chronic inflammatory process.

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Section: Medical Treatment Optionsmentioning

confidence: 99%

Section: Medical Treatment Optionsmentioning

confidence: 99%

The Role of Staphylococcus aureus in Patients with Chronic Sinusitis and Nasal Polyposis

Vickery

Ramakrishnan²,

Suh

2019

Curr Allergy Asthma Rep

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“…However, the potential side effects of oral steroids limit this approach . Topical steroids, including intranasal sprays, irrigations, gels, nebulizers, and drops, are attractive alternatives; however, they are less effective than oral steroids due to their difficulty in reaching the affected mucosa.…”

mentioning

confidence: 99%

Effects of mometasone furoate–impregnated biodegradable nasal dressing on endoscopic appearance in healing process following endoscopic sinus surgery: a randomized, double‐blind, placebo‐controlled study

Zhao

2018

Int Forum Allergy Rhinol

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Background Postoperative care is an important factor affecting the outcome of endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). The aim of this study was to test the effect of mometasone furoate (MF)‐soaked biodegradable nasal dressings (BNDs) on endoscopic appearance in CRS patients with nasal polyps (CRSwNP) after ESS. Methods This study was a prospective, randomized, double‐blinded, placebo‐controlled study. A total of 64 CRSwNP patients with bilateral ESS were enrolled and randomly given 4 mL or 8 mL of MF‐soaked BNDs (NasoPore) in 1 nasal cavity and the same amount of normal saline‐soaked BNDs in the contralateral side. The BNDs were removed on the 7th or 14th postoperative day. Perioperative sinus endoscopy (POSE) and Lund‐Kennedy scores were collected, on the 7th or 14th postoperative days and at 1, 2, and 3 postoperative months. Results The POSE and Lund‐Kennedy scores showed that in the 4‐mL, 1‐week group, no significant differences between the sides treated with MF‐soaked BNDs and the normal saline‐soaked control were observed at any postoperative visits. In the 4‐mL, 2‐week group, significant differences were found at the 2‐week and 1‐month postoperative visits but not at the 2‐month and 3‐month visits. In the 8‐mL, 1‐week group, significant differences were found at the 1‐week, 1‐month, and 2‐month postoperative visits but not at the 3‐month visit. In the 8‐mL, 2‐week group, significant differences were found at all postoperative visits. Conclusion This study reveals that MF‐impregnated BNDs improve the endoscopic appearance in the healing process of CRSwNP after ESS.

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“…In one study, steroid nasal irrigation provided a significant reduction in endoscopic score compared with pretreatment values and also improved patients’ quality of life . Although nasal steroids are commonly used after FESS, there has been only one study to report the effect of steroid irrigation after septoplasty . In that study the researchers recommended fluticasone propionate combined with a saline irrigation solution for 30 days .…”

Section: Discussionmentioning

confidence: 99%

Effects of early postoperative nasal decongestant on symptom relief after septoplasty

Dağlı¹,

Ocak

Mirici³

et al. 2018

Int Forum Allergy Rhinol

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Post‐operative corticosteroid irrigation for chronic rhinosinusitis after endoscopic sinus surgery: A meta‐analysis

Cited by 25 publications

References 24 publications

The Role of Staphylococcus aureus in Patients with Chronic Sinusitis and Nasal Polyposis

The Role of Staphylococcus aureus in Patients with Chronic Sinusitis and Nasal Polyposis

Effects of mometasone furoate–impregnated biodegradable nasal dressing on endoscopic appearance in healing process following endoscopic sinus surgery: a randomized, double‐blind, placebo‐controlled study

Effects of early postoperative nasal decongestant on symptom relief after septoplasty

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