Document Detail


Topical steroid drops for the treatment of sinus ostia stenosis in the postoperative period.
MedLine Citation:
PMID:  17181093     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chronic oral steroid use causes significant morbidity, including osteoporosis, immunosuppression, and adrenal insufficiency. Refractory chronic rhinosinusitis patients often take repeated oral steroid courses to treat polypoid disease or sinus ostia stenosis. This study evaluated topical steroid drop efficacy in treating recurrent sinus ostia stenosis in the postoperative period. METHODS: The 5-year single institution experience with topical steroid drop use after endoscopic sinus surgery (ESS) was evaluated by retrospective review. Patients were included if they began topical dexamethasone ophthalmic, prednisolone ophthalmic, or ciprofloxacin/ dexamethasone otic intranasally (used off-label) within 3 months after ESS. Outcomes (i.e., ostia patency, oral steroid use, revision surgery, and complications) were assessed for a 6-month period after steroid drop initiation. RESULTS: Thirty-six patients met inclusion criteria. Forty-four surgeries were performed during the study period; 67 sides were treated postoperatively with topical steroid drops. In 86.6% of cases, steroid drops were used to treat frontal ostium stenosis or frontal recess edema; 93.2% of surgeries were revision procedures. Sixty-four percent of sinuses were treated successfully with topical steroid drops, 14.9% remained stable, and 20.9% failed. Reasons for failure included persistent/worsening edema, scarring, or noncompliance. Ten patients (27.8%) required oral steroids and 4 patients (6%) underwent revision surgery during the study period. One case of adrenal suppression occurred. CONCLUSION: Topical steroid drops are beneficial in preventing sinus ostia stenosis in the postoperative period and may decrease the propensity toward repeated oral steroid therapy. This is particularly noteworthy in this challenging cohort, largely composed of revision frontal sinus surgery patients.
Authors:
John M DelGaudio; Sarah K Wise
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of rhinology     Volume:  20     ISSN:  1050-6586     ISO Abbreviation:  Am J Rhinol     Publication Date:    2006 Nov-Dec
Date Detail:
Created Date:  2006-12-21     Completed Date:  2007-02-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807268     Medline TA:  Am J Rhinol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  563-7     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, The Emory Clinic, 1365A Clifton Road NE, Suite 2100, Atlanta, GA 30322, USA. john_delgaudio@emoryhealthcare.org
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adolescent
Adult
Aged
Aged, 80 and over
Constriction, Pathologic
Edema / drug therapy*,  etiology
Endoscopy
Female
Follow-Up Studies
Glucocorticoids / administration & dosage*,  therapeutic use
Humans
Male
Middle Aged
Otorhinolaryngologic Surgical Procedures / methods*
Paranasal Sinuses*
Postoperative Period
Retrospective Studies
Sinusitis / surgery*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Glucocorticoids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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