Related Experiment Video
Updated: May 8, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
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.
Objective:
To compare the efficacy of corticosteroid irrigation (CSI) and intranasal corticosteroid spray (INCS) in reducing polyp size, improving nasal symptoms, and assessing HPA-axis suppression in non-surgical patients with chronic rhinosinusitis with nasal polyps (CRSwNP).
Methods:
Twenty-four patients from the Allergy and Rhinology Clinic, Songklanagarind Hospital, were randomized into: CSI + placebo spray (n = 13): Budesonide irrigation (0.5 mg/day) + saline spray. Placebo irrigation + INCS (n = 11): Saline irrigation + budesonide spray (512 mcg/day). Nasal symptoms were assessed using VAS-TNSS and SNOT-22. Polyp grading was evaluated via video nasal endoscopy using mLKS and Lildholdt's scale. Serum cortisol levels were measured at baseline, 4-12 weeks.
Results:
After 12 weeks, the CSI + placebo spray group showed a significant reduction in mLKS scores (8.54 ± 1.94 vs. 4.82 ± 1.94; p < 0.001), with greater improvement than the placebo irrigation + INCS group (Δ4 (3, 4) vs. Δ1 (0, 2); p = 0.003). VAS-TNSS and SNOT-22 scores showed no significant differences. Serum cortisol levels remained normal.
Conclusion:
Corticosteroid irrigation is more effective than nasal sprays in improving mLKS scores in non-surgical CRSwNP patients after 12 weeks, with no evidence of HPA-axis suppression.
Related Concept Videos
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
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...
01:30Epistaxis
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...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids