Document Detail

Effects of systemic steroid treatment in chronic polypoid rhinosinusitis evaluated with magnetic resonance imaging.
MedLine Citation:
PMID:  10187944     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aim of this prospective study was to evaluate the efficacy of a combined (local and systemic) steroid therapy on the extent of chronic polypoid rhinosinusitis and patient symptoms. METHODS AND PATIENTS: Subjects of this study were 20 patients with severe chronic polypoid rhinosinusitis with total or subtotal narrowing of the all sinuses. A nasal budesonide spray (2 x 0.1 mg/day) and an oral fluocortolone medication with a daily reduction during a 12-day period (total dose: 560 mg = group 1) and a 20-day period (total dose: 715 mg = group 2), respectively, were administered. Before and after the steroid treatment we evaluated the extent of the sinusitis with MRI and patient symptoms with symptom-related questionnaires. RESULTS: A significant reduction (> 30%) of the chronic polypoid rhinosinusitis was observed in 50% of MRI findings. The steroid effect on polypoid masses was heterogeneous in different anatomic areas (maxillary sinus 40%, anterior ethmoid 19%, posterior ethmoid 33%, sphenoidal sinus 61%, frontal sinus 46%). Most sinusitis-related symptoms were distinctly diminished in most patients (80%). No major side effects were observed. CONCLUSIONS: A combined short-term steroid therapy is highly effective in chronic polypoid rhinosinusitis, reducing the mucosal inflammation mainly in the large sinuses and reducing the incidence of symptoms significantly. However, this therapy was insufficient in the anterior ethmoid and cannot replace the current surgical treatment concept of the osteomeatal complex in CPR. The indication for such a short-term steroid therapy is the preoperative treatment. It facilitates functional endoscopic sinus surgery by reducing the extent of surgical procedures, the time, and thereby the risks of sinus surgery.
M Damm; M Jungehülsing; H E Eckel; M Schmidt; P Theissen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  120     ISSN:  0194-5998     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-04-19     Completed Date:  1999-04-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  517-23     Citation Subset:  IM    
ENT Department, University of Cologne, Germany.
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MeSH Terms
Administration, Inhalation
Administration, Oral
Anti-Inflammatory Agents / administration & dosage,  therapeutic use*
Budesonide / administration & dosage,  therapeutic use*
Chronic Disease
Drug Therapy, Combination
Fluocortolone / administration & dosage,  therapeutic use*
Glucocorticoids / administration & dosage,  therapeutic use*
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Middle Aged
Prospective Studies
Rhinitis / diagnosis,  drug therapy*,  pathology
Sinusitis / diagnosis,  drug therapy*,  pathology
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Glucocorticoids; 152-97-6/Fluocortolone; 51333-22-3/Budesonide

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