Prospective evaluation of oral corticosteroid as a predictor of postoperative olfactory recovery after functional endoscopic surgery for nasal polyposis

Rives, P.; Espitalier, F.; Michel, Guillaume; Blanc, François-Xavier; Fortun, C.; Malard, O.

doi:10.1007/s00405-019-05537-y

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…Hence, the absence of a clinically significant effect on olfaction after short‐course systemic steroids seems to predict that these patients will not benefit from surgery in terms of olfaction. This finding is in line with other recent research, which could demonstrate that patients who showed an olfactory improvement greater than 50% after systemic corticosteroid before surgery had a better rate of olfactory recovery postoperatively . However, the study by Rives et al was based on VAS only for olfactory measurement, the results of which have to be treated with caution …”

Section: Discussionsupporting

confidence: 89%

“…This finding is in line with other recent research, which could demonstrate that patients who showed an olfactory improvement greater than 50% after systemic corticosteroid before surgery had a better rate of olfactory recovery postoperatively. 33 However, the study by Rives et al was based on VAS only for olfactory measurement, the results of which have to be treated with caution. 28 Whether and how much CRS patients may benefit from steroids also seems dependent on CRS endotype with characteristics such as eosinophilia and the presence of nasal polyps.…”

Section: Discussionmentioning

confidence: 99%

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Response to Glucocorticosteroids Predicts Olfactory Outcome After ESS in Chronic Rhinosinusitis

et al. 2019

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Objectives Olfaction is frequently impaired in chronic rhinosinusitis with nasal polyps (CRSwNP) and often improves after endoscopic sinus surgery (ESS). Data about dynamics of olfactory changes after ESS are lacking, and little information is available concerning whether preoperatively administered glucocorticosteroids predict postoperative olfaction. Therefore, the aim of this study was to examine dynamics of olfaction after ESS in relation to the effect of preoperative administration of glucocorticosteroids in CRSwNP. Methods This prospective study included 52 CRSwNP patients (30 men, 22 women, mean age 54 ± 14 years) divided into a control group (n = 31) subjected to ESS without preoperative steroids and a treatment group (n = 21) receiving orally administered glucocorticosteroids preoperatively. Self‐ratings of olfaction and olfactory testing using the extended Sniffin’ Sticks test battery (threshold, discrimination and identification [TDI] score) were performed. Olfaction was measured preoperatively; after termination of glucocorticosteroid treatment (only treatment group); and 2 weeks, 1 month, and 3 months postoperatively. Results After glucocorticosteroids, TDI score significantly improved in 57% of patients, and olfactory function remained unchanged in 43%. In addition, improvement in TDI score after steroids and 3 months postoperatively were significantly correlated (r = 0.66, P = 0.01). Patients whose olfaction did not improve after glucocorticosteroids did not benefit from surgery. Regarding postoperative olfactory dynamics, TDI score reached its maximum 1 month postoperatively and decreased again approximately 3 months after surgery. Conclusion Glucocorticosteroids improved olfaction in CRSwNP comparable to surgery. In addition, changes in relation to steroids predicted olfactory outcome postoperatively. Regarding the olfactory dynamics, it could be demonstrated that olfactory function increased 1 month after surgery and decreased 3 months postoperatively. Level of Evidence 2 Laryngoscope, 130:1616–1621, 2020

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Response to Glucocorticosteroids Predicts Olfactory Outcome After ESS in Chronic Rhinosinusitis

et al. 2019

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“… Oral prednisolone did not appear to markedly affect the tissue eosinophil count. Low Prospective evaluation of oral corticosteroid as a predictor of postoperative olfactory recovery after functional endoscopic surgery for nasal polyposis [ 26 ] Rives 2019 Prospective 119 Oral prednisolone 1 mg/kg/day for 5 days preoperatively. Not mentioned.…”

Section: Resultsmentioning

confidence: 99%

Systemic corticosteroids in treatment of chronic rhinosinusitis—A systematic review

Tamene,

Dalhoff,

Schwarz

et al. 2023

European Clinical Respiratory Journal

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Purpose When first-line chronic rhinosinusitis (CRS) treatment fails, patients can either be treated with oral or injected systemic corticosteroids. Although the EPOS and international guidelines for CRS do not mention injected corticosteroids, it is commonly used by ear, nose, and throat specialists. While the risks of systemic corticosteroids, in general, are known, the pros and cons of injected and oral corticosteroids (OCS) in CRS treatment are unclear. Methods A systematic review of studies that report the effects and/or side effects of injected and oral corticosteroids in the treatment of CRS was made according to the PRISMA guidelines. Results Altogether, 48 studies were included, only five studies reported on injected corticosteroids, and five attended with side effects. Three studies found beneficial effects of OCS perioperatively on sinus surgery, while four articles found no effect. Nineteen articles reported that OCS resulted in an improvement in symptoms. Two articles presented a longer-lasting effect of injected corticosteroids than OCS. Three studies reported adverse side effects of systemic corticosteroids, while two studies showed no adverse side effects. One study showed less adrenal suppression after injected corticosteroids compared to OCS. The evidence is not strong but shows a positive effect of systemic corticosteroids that lasts longer with injections. Conclusion Although systemic corticosteroids are widely used to treat CRS, there is a lack of studies comparing the OCS and injected corticosteroids. The evidence is sparse, however, injected steroids show longer effects with fewer side effects. An RCT study is needed to compare OCS and injected corticosteroids.

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“…Decrease in smell function was demonstrated to be the most common improved symptom for CRS w/NP patients after systemic steroid treatment ( 23 ). Recently, two studies showed that the success of surgery on olfactory function was related to the response of the steroid treatment for CRS w/NP patients ( 24 , 25 ). According to the results of Bogdanov et al ( 24 ), ESS had no additional benefit on smell scores after steroid therapy.…”

Section: Discussionmentioning

confidence: 99%

Olfactory Neuroepithelium in Olfactory Cleft Polyps: Do They Have Any Effect on Olfaction Results After Endoscopic Sinus Surgery?

Özcan¹,

İsmi²,

Meşe³

et al. 2022

TAO

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Objective: How the presence of olfactory structures in olfactory cleft polyps (OCPs) affect olfaction function outcomes after surgical removal has not yet been investigated. In this study we aimed to assess the presence of olfactory structures in OCPs and correlate these findings with olfactory outcomes after endoscopic sinus surgery (ESS). Methods: Twenty seven patients with OCP underwent preoperative topical and systemic steroid treatment and ESS. Biopsies from the middle meatal polyps (MMPs) and OCPs were immunohistochemically analyzed for olfactory marker protein (OMP). The smell diskettes olfaction test was applied to patients at baseline, after steroid treatment (AST) and after ESS. Results: OCPs exhibited OMP staining more commonly and intensely compared to MMPs (p=0.008), however, there were no correlations between OMP staining scores and any of the olfaction scores (p>0.05). Steroid treatment increased smell function significantly (p<0.001), however, there were no significant differences between AST and after ESS smell scores (p=0.17). There were significant correlations between smell gains AST and final smell gains after ESS (r=0.665, p<0.001). Conclusion: OCPs contain olfactory neuroepithelium more commonly and intensely than MMPs in nasal polyp patients. However, surgical importance of this finding is controversial because removal of these polyps did not decrease smell function postoperatively in our study. Nasal polyp patients who will take steroid treatment pre-operatively must be informed that the success of ESS on olfaction depends on the response of the steroid treatment and ESS AST might not have additional favorable effect on smell function.

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Prospective evaluation of oral corticosteroid as a predictor of postoperative olfactory recovery after functional endoscopic surgery for nasal polyposis

Cited by 6 publications

References 17 publications

Response to Glucocorticosteroids Predicts Olfactory Outcome After ESS in Chronic Rhinosinusitis

Response to Glucocorticosteroids Predicts Olfactory Outcome After ESS in Chronic Rhinosinusitis

Systemic corticosteroids in treatment of chronic rhinosinusitis—A systematic review

Olfactory Neuroepithelium in Olfactory Cleft Polyps: Do They Have Any Effect on Olfaction Results After Endoscopic Sinus Surgery?

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