Topical steroids for nasal polyps

Kalish, Larry; Snidvongs, Kornkiat; Sivasubramaniam, Rahuram; Cope, Daron; Harvey, Richard J.

doi:10.1002/14651858.cd006549.pub3

Cited by 19 publications

(23 citation statements)

References 99 publications

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“…7,702,[1008][1009][1010][1011][1012] When compared to placebo, pooled data analyses of symptoms, polyp size, polyp recurrence, and nasal airflow have demonstrated significant benefit in favor of the topical corticosteroid irrespective of the variations in which these outcomes have been reported. It has also been possible to do subgroup analysis 7 on:…”

Section: Viiie1 Crswnp Management:-saline (Spray and Irrigation)mentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

544

879

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Viiie1 Crswnp Management:-saline (Spray and Irrigation)mentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

544

879

View full text Add to dashboard Cite

show abstract

“…A recent meta-analysis showed that topical steroid is effective against sinonasal symptoms in patients with CRS without nasal polyps [11], and it decreases polyp size [12,13] and prevents polyp recurrence in CRS with nasal polyps [12]. The literature contains a number of different findings concerning the use of nasal steroid spray after ESS.…”

Section: Discussionmentioning

confidence: 99%

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

Kang¹,

Chung²,

Cho³

et al. 2016

Clin Exp Otorhinolaryngol

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Objectives. Budesonide nasal irrigation was introduced recently for postoperative management of patients with chronic rhinosinusitis. The safety and therapeutic effectiveness of this procedure is becoming accepted by many physicians. The objective of this study was to evaluate the efficacy of postoperative steroid irrigation in patients with chronic rhinosinusitis and asthma.Methods. This prospective study involved 12 chronic rhinosinusitis patients with nasal polyps and asthma who received oral steroid treatment for recurring or worsening disease. The 22-item Sinonasal Outcomes Test (SNOT-22) and LundKennedy endoscopy scores were checked before nasal budesonide irrigation, and 1, 2, 4, and 6 months after irrigation. We also calculated the total amount of oral steroids and inhaled steroids in the 6 months before irrigation and the 6 months after it.

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“…A Cochrane Database Review from 2012 concluded that topical steroids are beneficial in the treatment of CRSwNP and that the adverse effects are minor. 26 They improved symptoms, reduced polyp size, and prevented polyp recurrence after surgery. 26 This was confirmed by a grade A recommendation for the use of intranasal steroids for the treatment of CRSwNP by the EPOS in 2012.…”

Section: Crswnp Topical or Oral Steroidsmentioning

confidence: 96%

“…26 They improved symptoms, reduced polyp size, and prevented polyp recurrence after surgery. 26 This was confirmed by a grade A recommendation for the use of intranasal steroids for the treatment of CRSwNP by the EPOS in 2012. 23 In fact, a double-blind, placebo-controlled study by Aukema et al 27 in 2005, showed that intranasal fluticasone 400 mcg daily over the course of 12 weeks resulted in 13 of 27 patients with CRSwNP (48%) not needing sinus surgery who previously had an indication for sinus surgery compared with 6 of 27 (22%) in the placebo group 27 Oral steroids are often used in the treatment of nasal polyps.…”

Section: Crswnp Topical or Oral Steroidsmentioning

confidence: 96%