Our Summary

This research paper is about a study conducted on chronic rhinosinusitis (CRS), a long-term inflammation of the nasal and sinus lining that lasts more than 12 weeks without any symptom relief. The current treatment for CRS is medication, possible sinus surgery, and a post-surgery topical treatment. However, there is no agreement on the best type and duration of medical treatment.

This study specifically examined the use of high volume budesonide nasal irrigation (a type of steroid used to reduce inflammation). The researchers wanted to see if this method was effective in reducing CRS symptoms and if it was safe. They measured symptom reduction using two scoring systems (SNOT-22 scores and Lund-Kennedy endoscopic scores) and safety by testing serum cortisol levels and eye pressure.

The study included 66 patients who had tried other treatments for CRS without success. These patients underwent sinus surgery and then had one of their nasal cavities treated with normal saline irrigation (the control group) and the other with budesonide irrigation.

The results showed that the budesonide treatment significantly reduced the scores for both symptom tests compared to the control. Also, more patients reported total improvement with the budesonide treatment. The researchers concluded that high volume budesonide irrigation is safe and more effective than normal saline irrigation. They recommend further studies with more participants and longer treatment duration to confirm these findings.

FAQs

  1. What is currently the standard treatment for chronic rhinosinusitis (CRS)?
  2. What method did the researchers use to measure the effectiveness and safety of the budesonide treatment?
  3. What were the key findings of the study on the use of high volume budesonide nasal irrigation for CRS?

Doctor’s Tip

A helpful tip a doctor might tell a patient about nasal polyp removal is to follow post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include avoiding certain activities, using prescribed medications as directed, and attending follow-up appointments with your healthcare provider. Additionally, maintaining good nasal hygiene, such as using saline nasal rinses, can help prevent the recurrence of nasal polyps.

Suitable For

Patients who are typically recommended for nasal polyp removal are those with chronic rhinosinusitis (CRS) who have not had success with other treatments such as medication and sinus surgery. These patients may have severe symptoms such as nasal congestion, facial pain or pressure, and decreased sense of smell. They may also have nasal polyps, which are noncancerous growths in the lining of the nasal passages or sinuses that can block airflow and lead to chronic inflammation. Patients with CRS may also have recurrent sinus infections, a history of asthma, or allergies.

In the study mentioned above, patients with CRS who had failed other treatments were selected to undergo sinus surgery and then receive either normal saline irrigation or budesonide irrigation. This suggests that patients with CRS who have not responded well to conventional treatments may be good candidates for nasal polyp removal and alternative treatments such as budesonide irrigation.

Timeline

Before nasal polyp removal:

  • Patient experiences symptoms of chronic rhinosinusitis (CRS) such as nasal congestion, facial pain, headache, and loss of smell
  • Patient may try various medications and treatments for CRS without success
  • Patient may undergo sinus surgery as a last resort treatment option

After nasal polyp removal:

  • Patient undergoes sinus surgery to remove nasal polyps
  • Patient receives post-surgery topical treatment, which may include high volume budesonide nasal irrigation
  • Patient’s symptoms of CRS are measured using scoring systems such as SNOT-22 scores and Lund-Kennedy endoscopic scores
  • Patient’s safety is monitored through testing serum cortisol levels and eye pressure
  • Patient experiences significant reduction in CRS symptoms with budesonide treatment compared to normal saline irrigation
  • Patient reports total improvement in symptoms with budesonide treatment
  • Researchers conclude that high volume budesonide irrigation is safe and effective for reducing CRS symptoms, recommend further studies to confirm findings

What to Ask Your Doctor

  1. What are the benefits of nasal polyp removal surgery?
  2. What are the risks and potential complications associated with nasal polyp removal surgery?
  3. What type of anesthesia will be used during the surgery?
  4. How long is the recovery period after nasal polyp removal surgery?
  5. What are the expected outcomes of the surgery in terms of symptom relief and improvement in quality of life?
  6. Are there any alternative treatments to consider before opting for nasal polyp removal surgery?
  7. How often will follow-up appointments be needed after the surgery?
  8. Will there be any restrictions or limitations on activities after the surgery?
  9. What can I do to help prevent nasal polyps from recurring after surgery?
  10. Are there any specific post-operative care instructions or medications that will be necessary for optimal recovery?

Reference

Authors: Kothiwala M, Samdani S, Grover M, Gurjar V. Journal: Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1399-1407. doi: 10.1007/s12070-021-02509-9. Epub 2021 Apr 15. PMID: 36452810