Therapeutic indications for sinonasal topical steroid treatment and its effects on eosinophilic chronic rhinosinusitis after endoscopic sinus surgery

Abstract

Objective This study evaluated the post-operative indications for sinonasal topical steroid treatment using a corticosteroid (steroid)-eluting, sinus-bioabsorbable device and its effects in patients with eosinophilic chronic rhinosinusitis. Method Post-operative courses were investigated in two groups: group A with patients who underwent sinonasal topical steroid treatment, and group B with control patients who did not. Results Group A was significantly younger than group B (p < 0.01), and the pre-operative computed tomography score was significantly higher in group A than in group B (p < 0.05). In the post-operative stage, the nasal symptoms questionnaire component of olfactory loss and the post-operative endoscopic appearance score were significantly worse in group A than in group B (p < 0.01). Conclusion These data suggest that younger age, more severe rhinosinusitis and post-operative olfactory loss led to the need for sinonasal topical steroid treatment to prevent relapsing inflammation after functional endoscopic sinus surgery in patients with eosinophilic chronic rhinosinusitis.

Usefulness of post-operative endoscopic score for optimal treatment selection in recurrent eosinophilic chronic rhinosinusitis

“…Sinonasal topical steroid treatment Sinonasal topical steroid treatment using a bioabsorbable device consisting of oxidised regenerated cellulose (Surgicel Absorbable Haemostat; Johnson and Johnson, Tokyo, Japan) and triamcinolone acetonide (Kenacort, 40 mg/ml vial; Bristol Myers Squibb, Tokyo, Japan) was used, based on previous reports. 16,17 First, cotton swabs impregnated with 4 per cent xylocaine and 5000-fold diluted adrenaline were bilaterally inserted into the surgically opened ethmoid sinuses and olfactory clefts, to shrink the nasal mucosae, for 5-10 minutes. Second, a moderate amount of oxidised regenerated cellulose was inserted bilaterally into the ethmoid sinuses and olfactory clefts.…”

Efficacy functional endoscopic sinus surgery (FESS) for the treatment of chronic rhinosinusitis

“…Today, functional endoscopic sinus surgery (FESS) is the preferred method for treating chronic rhinosinusitis that does not improve with medication. Endoscopic sinus surgery is becoming more and more popular every day 15 . Our capacity to identify and treat sinus disease has substantially benefited from significant advancements in imaging, technology, and philosophy.…”