Document Detail


Treatment of recurrent sinonasal polyposis with steroid-infused carboxymethylcellulose foam.
MedLine Citation:
PMID:  21144224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recurrence of sinonasal polyposis after endoscopic sinus surgery can be difficult to manage. Topical steroid sprays and irrigations may not provide adequate treatment and systemic steroid therapy is limited by side effects. This study was designed to evaluate the efficacy of steroid-infused carboxymethylcellulose (CMC) foam as a treatment for recurrence of chronic rhinosinusitis with nasal polyposis after endoscopic sinus surgery.
METHODS: A prospective cohort study was performed enrolling patients with recurrent sinonasal polyposis after endoscopic sinus surgery. All patients had development of symptomatic polyp disease despite aggressive postoperative topical steroid treatment. The study treatment entailed endoscopic placement of 4 mL of CMC foam hydrated with triamcinolone, 40 mg/mL (Kenalog 40; Bristol-Myers Squibb, New York, NY), into the ethmoid cavities bilaterally. Patients were evaluated using videoendoscopy and the Sino-Nasal Outcomes Test 20 (SNOT-20) at three time points: immediately before treatment, 7-14 days after treatment, and 28-35 days after treatment. The videoendoscopies were randomized and scored in a blinded fashion using a modification of the perioperative sinus endoscopy (POSE) scoring system.
RESULTS: Ten treatments were performed in eight patients; two patients underwent two treatments each. Mean SNOT-20 score improved at both 1 week and 1 month after treatment (2.44 versus 1.65, p < 0.05, and 2.44 versus 1.36, p < 0.01, respectively). Videoendoscopy also revealed improvement when evaluated with the modified POSE score at 1 week (11.8 versus 8.2, p < 0.001), and 1 month (11.8 versus 7.9, p < 0.001).
CONCLUSION: Endoscopic placement of steroid-infused CMC foam improves symptoms and endoscopic findings in patients with recurrent sinonasal polyposis after endoscopic sinus surgery.
Authors:
Steven D Pletcher; Andrew N Goldberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of rhinology & allergy     Volume:  24     ISSN:  1945-8932     ISO Abbreviation:  Am J Rhinol Allergy     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-03-25     Revised Date:  2011-11-10    
Medline Journal Info:
Nlm Unique ID:  101490775     Medline TA:  Am J Rhinol Allergy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  451-3     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, University of California-San Francisco, 2233 Post Street, San Francisco, CA 94115, USA. spletcher@ohns.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Carboxymethylcellulose Sodium / administration & dosage*
Chronic Disease
Cohort Studies
Endoscopy
Humans
Middle Aged
Nasal Polyps / drug therapy*
Prospective Studies
Recurrence
Sinusitis / drug therapy*
Triamcinolone Acetonide / administration & dosage*,  pharmacokinetics
Chemical
Reg. No./Substance:
76-25-5/Triamcinolone Acetonide; 9004-32-4/Carboxymethylcellulose Sodium

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


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