| Effects of systemic steroid treatment in chronic polypoid rhinosinusitis evaluated with magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 10187944 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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M Damm; M Jungehülsing; H E Eckel; M Schmidt; P Theissen |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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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:
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Created Date: 1999-04-19 Completed Date: 1999-04-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8508176 Medline TA: Otolaryngol Head Neck Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 517-23 Citation Subset: IM |
Affiliation:
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ENT Department, University of Cologne, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Inhalation Administration, Oral Adult Aged Anti-Inflammatory Agents / administration & dosage, therapeutic use* Budesonide / administration & dosage, therapeutic use* Chronic Disease Drug Therapy, Combination Female Fluocortolone / administration & dosage, therapeutic use* Glucocorticoids / administration & dosage, therapeutic use* Humans Image Processing, Computer-Assisted Magnetic Resonance Imaging Male Middle Aged Polyps Prospective Studies Rhinitis / diagnosis, drug therapy*, pathology Sinusitis / diagnosis, drug therapy*, pathology |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents; 0/Glucocorticoids; 152-97-6/Fluocortolone; 51333-22-3/Budesonide |
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