Document Detail


A prospective, randomised, placebo-controlled trial of postoperative oral steroid in allergic fungal sinusitis.
MedLine Citation:
PMID:  19714349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study is to determine the effectiveness of postoperative oral steroid in controlling disease in patients with allergic fungal sinusitis (AFS). The study design includes prospective, randomised, double blind,placebo-controlled trial using oral prednisolone.Twenty-four patients diagnosed with AFS underwent sinus surgery (endoscopic sinus surgery with or without open surgery) to completely excise disease. Patients were randomised to receive either oral steroid (n = 12) or placebo(n = 12) soon after surgery. All patients were also administered itraconazole and steroid nasal spray in the postoperative period. Subjective evaluation of symptom relief and objective evaluation by rigid nasal endoscopy at 6 and 12 weeks following surgery was performed. After12 weeks, the code was broken and the two groups of patients were identified to note their response to treatment.At 6 weeks, complete relief of preoperative symptoms was obtained in eight patients who had received oral steroid and none who had received placebo (p = 0.001). Partial relief of preoperative symptoms was obtained in four who had received oral steroid and eight who had received placebo.Nasal endoscopy revealed that 8 of 12 patients who had received oral steroid and 1 patient who had received placebo were disease free (p = 0.009). At 12 weeks, complete symptom relief was obtained by all patients who received oral steroid but only one who received placebo(p = 0.0001). Nasal endoscopy at 12 weeks revealed that all 12 patients who had received oral steroid and only 1 patient (the same patient) who had received placebo were disease free (p = 0.0001). In conclusion, postoperative oral steroid in a tapering dose produces significant subjective and objective improvement of patients with AFS. It is also effective in preventing early recurrence. Inclusion of post operative oral steroid therapy for at least 12 weeks is recommended in all patients who undergo excisive surgery for AFS.
Authors:
V Rupa; Mary Jacob; Mary Somini Mathews; Mandalam S Seshadri
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery     Volume:  267     ISSN:  1434-4726     ISO Abbreviation:  Eur Arch Otorhinolaryngol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-04     Completed Date:  2010-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9002937     Medline TA:  Eur Arch Otorhinolaryngol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  233-8     Citation Subset:  IM    
Affiliation:
Department of ENT, Christian Medical College and Hospital,Vellore 632004, India. rupavedantam@cmcvellore.ac.in
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adolescent
Adult
Dose-Response Relationship, Drug
Double-Blind Method
Female
Follow-Up Studies
Glucocorticoids / administration & dosage*
Humans
Hypersensitivity / drug therapy*,  immunology,  surgery
Male
Middle Aged
Mycoses / drug therapy*,  immunology,  surgery
Postoperative Care / methods*
Prednisolone / administration & dosage*
Prospective Studies
Recurrence / prevention & control
Sinusitis / drug therapy,  immunology,  surgery*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Glucocorticoids; 50-24-8/Prednisolone

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


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