Abstract
Objective: Rhinosinusitis and polyposis in Samter triad is difficult to treat, commonly recurring despite sinus surgery, antibiotics, and/or nasal steroids. Systemic steroids are limited by side effects. The present study assesses the efficacy of a gel placed into the sinuses, releasing steroids and antibiotics, along with topical nebulization of the same medications.
Method: Ten Samter patients with recurrent rhinosinusitis after sinus surgery received weekly intra-sinus placement of a hydroxycellulose gel-releasing mometasone and antibiotics, along with endoscopic sinus debridement, for 6 weeks. Outcome was evaluated by Lund-Kennedy (LK) endoscopic and symptom scales immediately, 3 weeks, 6 weeks, and 10 weeks after the beginning of the protocol.
Results: Both LK symptoms and endoscopic scores showed a progressive and statistically significant decline throughout the course of therapy, reaching at the end of treatment 56% (P = .003) and 59% (P = .004) improvement of pretreatment values, respectively. At 1 month posttreatment, mild relapse was noted.
Conclusion: A topical membrane therapy regimen consisting of gel-releasing corticosteroids and antibiotics, along with topically nebulized corticosteroids and antibiotics, regular saline hydrotherapy, and sinus debridement, improves symptoms and endoscopic findings in recurrent Samter sinonasal polyposis.
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