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Does amphotericin B nasal douching help prevent polyp recurrence following functional endoscopic sinus surgery?
Sayyed Mostafa Hashemi1, Farhad Mokhtarinejad, Maryam Karim
1Associate Professor of Otolaryngology, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Summary
Topical amphotericin B did not improve nasal polyposis recurrence after surgery compared to normal saline. Standard saline nasal douching remains a recommended treatment following functional endoscopic sinus surgery for polyposis.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Innovation
Background:
- Nasal polyposis frequently recurs after surgery.
- Antifungal therapy, specifically amphotericin B, has been explored to mitigate recurrence and severity.
- Recent evidence questions the efficacy of antifungal treatments for nasal polyposis.
Purpose of the Study:
- To evaluate the efficacy of topical amphotericin B nasal irrigation versus normal saline in reducing nasal polyposis recurrence post-surgery.
- To compare the impact of amphotericin B and normal saline on disease staging after functional endoscopic sinus surgery.
Main Methods:
- A prospective case-control clinical trial involving 50 nasal polyposis patients undergoing functional endoscopic sinus surgery.
- Preoperative and 6-month postoperative CT scans were used for disease staging.
- Patients were randomized to receive either amphotericin B nasal irrigation or normal saline nasal irrigation for six months.
Main Results:
- Both groups showed disease improvement, with 84% in the amphotericin B group and 22 patients (in the normal saline group) showing improvement in imaging stage.
- No significant difference in the reduction of imaging stage was observed between the amphotericin B and normal saline groups.
- Allergies were reported by 68% of the normal saline group and 84% of the amphotericin B group.
Conclusions:
- Topical amphotericin B nasal irrigation offers no significant benefit over normal saline for treating nasal polyposis post-surgery.
- Normal saline nasal douching is a viable and recommended traditional treatment following functional endoscopic sinus surgery for polyposis.
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