Related Experiment Video
Updated: May 8, 2025
06:13
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
16.5K
A Randomized, Double-Blind Study Comparing Corticosteroid Irrigations and Nasal Sprays for Polyp Size Reduction in
Chakapan Promsopa1, Thanapa Quannuy1, Suchet Chinpairoj1
1Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
The Laryngoscope
|May 7, 2025
Summary
Corticosteroid irrigation significantly reduced nasal polyp size more effectively than intranasal corticosteroid sprays in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Both treatments were safe, with no HPA-axis suppression observed.
Area of Science:
- Otolaryngology
- Allergy and Immunology
- Pharmacology
Background:
- Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly impacts quality of life.
- Current treatments aim to reduce polyp burden and improve sinonasal symptoms.
- The efficacy and safety of different corticosteroid delivery methods require further investigation.
Purpose of the Study:
- To compare the effectiveness of corticosteroid irrigation (CSI) versus intranasal corticosteroid spray (INCS) in managing CRSwNP.
- To assess the impact of these treatments on nasal polyp size, sinonasal symptoms, and hypothalamic-pituitary-adrenal (HPA) axis function.
- To evaluate treatment outcomes in non-surgical CRSwNP patients.
Main Methods:
- A randomized controlled trial involving 24 non-surgical CRSwNP patients.
- Group 1 received budesonide irrigation (CSI) plus a placebo spray.
- Group 2 received saline irrigation plus budesonide spray (INCS).
- Outcomes included polyp grading (mLKS), symptom scores (VAS-TNSS, SNOT-22), and serum cortisol levels over 12 weeks.
Main Results:
- Corticosteroid irrigation (CSI) demonstrated a statistically significant reduction in polyp size (mLKS scores) compared to intranasal corticosteroid spray (INCS) after 12 weeks (p < 0.001).
- While CSI showed greater improvement in mLKS scores, no significant differences were observed in overall nasal symptom scores (VAS-TNSS, SNOT-22) between the groups.
- Serum cortisol levels remained within normal ranges for both treatment groups, indicating no HPA-axis suppression.
Conclusions:
- Corticosteroid irrigation is a more effective treatment for reducing nasal polyp size in non-surgical CRSwNP patients compared to intranasal corticosteroid sprays.
- Both CSI and INCS appear to be safe, with no observed adverse effects on HPA-axis function.
- Further research may explore the long-term efficacy and patient-reported outcomes of CSI in CRSwNP management.
Related Concept Videos
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
131
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
131
01:30Epistaxis
98
Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
98
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
84
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
84