Abstract
Objectives:
1) Describe the current evidence for middle-meatal steroid-eluting spacers in patients with chronic rhinosinusitis (CRS) following endoscopic sinus surgery (ESS) 2) Evaluate the need for postoperative systemic corticosteroids in CRS patients with nasal polyposis when using a steroid-eluting middle meatal spacer following ESS.
Methods:
CRS patients with nasal polyposis who failed medical therapy and elected ESS (n=36) were enrolled into this randomized, double-blind, placebo controlled trial. Patients were randomized into either a treatment arm (postoperative prednisone 30 mg once daily for 7 days; n=18) or placebo arm (placebo pill once daily for 7 days =18). Therapeutic outcomes were evaluated at 1 week, 3 weeks, and 2 months postoperatively. Primary outcome was endoscopic grading using the Lund-Kennedy scoring system. Secondary outcome included disease-specific quality of life (QoL) using the SNOT-22 survey.
Results:
Both study arms received significant improvement in endoscopic grading and disease-specific QoL from baseline compared to the two-month follow-up (p0.119).
Conclusions:
Minimizing the use of systemic corticosteroids in patients with CRS may avoid unwanted adverse events. Results from this study suggest that when using a middle meatal steroid-eluting spacer during ESS for patients with nasal polyposis, postoperative systemic corticosteroids may not significantly improve short-term endoscopic and disease-specific QoL.
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