Comparison of outcomes of triamcinolone versus normal saline soaked polyvinyl alcohol pack following bilateral endoscopic sinus surgery

Gyawali, Bigyan Raj; Pradhan, B.; Thapa, Neeraj

doi:10.4193/rhin19.004

Cited by 8 publications

(9 citation statements)

References 11 publications

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“…Gyawali et al 2258 reported an RCT of 58 patients comparing triamcinolone‐impregnated polyvinyl alcohol packs placed as a spacer, with saline‐impregnated packs, which were removed on day 2. The side for the triamcinolone pack was chosen randomly and the opposite side served as the saline control; observers were blinded to side.…”

Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

458

479

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I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

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Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

458

479

View full text Add to dashboard Cite

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“…Although most of the studies showed a trend favoring steroid use, 10,13,[16][17][18][19][20][21][22][23][27][28][29][30] some studies still demonstrated a favorable trend toward no steroids. This phenomenon might be due to nasal irrigation or postoperative oral steroids in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of the outcome of Lund–Kennedy scores, most of the studies showed a decrease in endoscopic score to near perfect in the steroid group 26 after 2 weeks postoperatively. Although most of the studies showed a trend favoring steroid use, 10,13,16–23,27–30 some studies still demonstrated a favorable trend toward no steroids. This phenomenon might be due to nasal irrigation or postoperative oral steroids in both groups 15 .…”

Section: Discussionmentioning

confidence: 99%

Effects of implants with steroids after endoscopic sinus surgery: A systematic review with meta‐analysis of randomized controlled trials

Kao

Huang

Tsai

et al. 2021

Int Forum Allergy Rhinol

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Background Chronic rhinosinusitis affects approximately 5%−2% of the general population worldwide. Steroid implants after endoscopic sinus surgery (ESS) have drawn considerable interest for their cost savings, but relevant guidelines indicate that evidence on this topic is of low quality with high heterogeneity. The purpose of this study was to examine the efficacy of steroid implants after ESS by synthesizing relevant randomized controlled trials (RCTs). Methods Two authors independently assessed the eligibility of potential references from five biomedical databases. They further extracted relevant data from the included studies, including (a) mean, standard deviation, or standard error for Lund–Kennedy endoscopic (LKE) score and Perioperative Sinus Endoscopy (POSE) score and (b) events and sample sizes of each group for further intervention. Data were pooled in a random‐effects model, and results were presented as the weighted mean difference (WMD) or risk ratio (RR) with 95% confidence interval (CI) and I2. Results Eleven RCTs (n = 853) were included and showed that the steroid implant group had lower LKE scores (WMD, ‐1.19; 95% CI, ‐1.75 to ‐0.62; I2 = 0%) and POSE scores (WMD, ‐1.62; 95% CI, ‐2.47 to ‐0.76; I2 = 48%) than the placebo implant group at postoperative week 2. Moreover, the reoperation rate in the steroid implant group was also lower than in the placebo implant group (RR, 0.49; 95% CI, 0.30 to 0.80; I2 = 0%). However, no significant difference was observed in the postoperative oral steroid requirement between both groups. Conclusions Collectively, steroid implant decreases LKE and POSE among patients receiving ESS in the short term, but long‐term effects remain unclear. Patient‐based outcomes are worth further discussion in the future.

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“…However, the pricing is higher than that of nasal packing which could well be a reason not to implement this strategy (178) . Infiltrating nasal polyvinyl alcohol packs with triamcinolone showed additional benefit in the postoperative recovery (179) .…”

Section: Surgery and Post-operative Care In Crsmentioning

confidence: 98%

Rhinology in review: from COVID-19 to biologicals

Fokkens¹,

Landis²,

Hopkins³

et al. 2021

Rhin

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We look back at the end of what soon will be seen as an historic year, from COVID-19 to real-world introduction of biologicals influencing the life of our patients. This review describes the important findings in Rhinology over the past year. A large body of evidence now demonstrates loss of sense of smell to be one of the most common symptoms of COVID-19 infection; a meta-analysis of 3563 patients found the mean prevalence of self-reported loss to be 47%. A number of studies have now shown long-term reduced loss of smell and parosmia. Given the high numbers of people affected by COVID-19, even with the best reported recovery rates, a significant number worldwide will be left with severe olfactory dysfunction. The most prevalent causes for olfactory dysfunction, besides COVID-19 and upper respiratory tract infections in general, are trauma and CRSwNP. For these CRSwNP patients a bright future seems to be starting with the development of treatment with biologics. This year the Nobel prize in Medicine 2021 was awarded jointly to David Julius and Ardem Patapoutian for their discoveries of receptors for temperature and touch which has greatly enhanced our understanding of nasal hyperreactivity and understanding of intranasal trigeminal function. Finally, a new definition of chronic rhinitis has been proposed in the last year and we have seen many papers emphasizing the importance of endotyping patients in chronic rhinitis and rhinosinusitis in order to optimise treatment effect.

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Comparison of outcomes of triamcinolone versus normal saline soaked polyvinyl alcohol pack following bilateral endoscopic sinus surgery

Cited by 8 publications

References 11 publications

International consensus statement on allergy and rhinology: rhinosinusitis 2021

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Effects of implants with steroids after endoscopic sinus surgery: A systematic review with meta‐analysis of randomized controlled trials

Rhinology in review: from COVID-19 to biologicals

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