Rhinotopic therapy for refractory chronic rhinosinusitis: a study of 20 cases.

Area of Science:

• Otolaryngology
• Rhinology
• Medical Treatments

Background:

• Refractory chronic rhinosinusitis (CRS) poses management challenges post-endoscopic sinus surgery.
• Developing effective treatment protocols for persistent CRS is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of a novel rhinotopic protocol for treating refractory CRS.
• To assess symptom improvement and endoscopic changes in patients with refractory CRS.

Main Methods:

• A prospective pilot study involving 20 patients with refractory CRS.
• A 6-week rhinotopic protocol including saline rinses, nebulized corticosteroids, and antibiotics, followed by weekly debridement and topical sinus treatment.
• Outcomes measured using Lund-Kennedy symptom and endoscopic appearance scores over 30 weeks.

Main Results:

• Significant symptom score improvement: 77% at 6 weeks, peaking at 95% post-therapy, and 65% at 24 weeks.
• Significant endoscopic appearance score improvement: 84% at 6 weeks, peaking at 96% post-therapy, and 75% at 24 weeks.
• Sinus cultures showed no growth or normal flora in 90% of patients post-therapy.

Conclusions:

• The rhinotopic protocol demonstrated statistically significant efficacy in managing refractory CRS.
• While initial improvements were substantial, a gradual decline in benefits was observed during the follow-up period.
• The rhinotopic protocol offers a viable treatment option for refractory chronic rhinosinusitis.