Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-23T16:19:56.593Z Has data issue: false hasContentIssue false

Therapeutic indications for sinonasal topical steroid treatment and its effects on eosinophilic chronic rhinosinusitis after endoscopic sinus surgery

Published online by Cambridge University Press:  23 August 2021

T Saito*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya, Japan
K Okazaki
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya, Japan
Y Hamada
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya, Japan
K Hashimoto
Affiliation:
Department of Otorhinolaryngology, Hospital of Kawanishi City, Kawanishi, Japan
K Tsuzuki
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya, Japan
*
Author for correspondence: Dr T Saito, Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo663-8501, Japan E-mail: [email protected] Fax: +81 798 41 8976

Abstract

Objective

This study evaluated the post-operative indications for sinonasal topical steroid treatment using a corticosteroid (steroid)-eluting, sinus-bioabsorbable device and its effects in patients with eosinophilic chronic rhinosinusitis.

Method

Post-operative courses were investigated in two groups: group A with patients who underwent sinonasal topical steroid treatment, and group B with control patients who did not.

Results

Group A was significantly younger than group B (p < 0.01), and the pre-operative computed tomography score was significantly higher in group A than in group B (p < 0.05). In the post-operative stage, the nasal symptoms questionnaire component of olfactory loss and the post-operative endoscopic appearance score were significantly worse in group A than in group B (p < 0.01).

Conclusion

These data suggest that younger age, more severe rhinosinusitis and post-operative olfactory loss led to the need for sinonasal topical steroid treatment to prevent relapsing inflammation after functional endoscopic sinus surgery in patients with eosinophilic chronic rhinosinusitis.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr T Saito takes responsibility for the integrity of the content of the paper

References

Fokkens, WJ, Lund, VJ, Hopkins, C, Hellings, PW, Kern, R, Reitsma, S. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology 2020;58:1464CrossRefGoogle ScholarPubMed
Fujieda, S, Imoto, Y, Kato, Y, Ninomiya, T, Tokunaga, T, Tsutsumiuchi, T et al. Eosinophilic chronic rhinosinusitis. Allergol Int 2019;68:403–12CrossRefGoogle ScholarPubMed
Haruna, S, Otori, N, Yanagi, K, Moriyama, H. Eosinophilic sinusitis [in Japanese]. Oto-Rhino-Laryngol Tokyo 2001;44:195201Google Scholar
Tokunaga, T, Sakashita, M, Haruna, T, Asaka, D, Takeno, S, Ikeda, H. Novel scoring system and algorithm for classifying chronic rhinosinusitis: the JESREC Study. Allergy 2015;70:9951003CrossRefGoogle ScholarPubMed
Rudmik, L. Economics of chronic rhinosinusitis. Curr Allergy Asthma Rep 2017;17:20CrossRefGoogle ScholarPubMed
Tomassen, P, Vandeplas, G, Van Zele, T. Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers. J Allergy Clin Immunol 2016;137:1449–56CrossRefGoogle ScholarPubMed
Okushi, T, Mori, E, Nakayama, T, Asaka, D, Matsuwaki, Y, Ota, K. Impact of residual ethmoid cells on postoperative course after endoscopic sinus surgery for chronic rhinosinusitis. Auris Nasus Larynx 2012;39:484–9CrossRefGoogle ScholarPubMed
DeConde, AS, Mace, JC, Levy, JM, Rudmik, L, Alt, JA, Smith, TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope 2017;127:550–5CrossRefGoogle ScholarPubMed
Grennan, D, Wang, S. Steroid side effects. JAMA 2019;322:282CrossRefGoogle ScholarPubMed
Miwa, T, Furuta, A, Shiga, H, Ikeda, K, Kondo, K, Tsuzuki, K et al. Clinical practice guidelines for the management of biolfactory dysfunction – secondary publication. Auris Nasus Larynx 2019;46:653–62CrossRefGoogle ScholarPubMed
Rudmik, L, Hoy, M, Schlosser, RJ, Harvey, RJ, Welch, KC, Lund, V et al. Topical therapies in the management of chronic rhinosinusitis: an evidence-based review with recommendations. Int Forum Allergy Rhinol 2013;3:281–98CrossRefGoogle ScholarPubMed
Bardaranfar, MH, Ranjbar, Z, Dadgarnia, MH, Atighechi, S, Mirvakili, A, Behniafardet, N et al. The effect of an absorbable gelatin dressing impregnated with triamcinolone within the olfactory cleft on polypoid rhinosinusitis smell disorders: Am J Rhinol Allergy 2014;28:172‒5CrossRefGoogle ScholarPubMed
Konno, W, Kashiwagi, T, Tsunemi, Y, Goto, K, Haruna, S. Long-term postoperative control of eosinophilic chronic rhinosinusitis recurrence by inserting a steroid-eluting, sinus-bioabsorbable device reduces the dosage of oral steroid. Auris Nasus Larynx 2019;46:365–73CrossRefGoogle ScholarPubMed
Saito, T, Tsuzuki, K, Nishikawa, H, Okazaki, K, Hashimoto, K, Sakagami, M. Nasal symptoms questionnaire: our proposed scoring system and prognostic factors in chronic rhinosinusitis. ORL J Otorhinolaryngol Relat Spec 2018;80:296306CrossRefGoogle ScholarPubMed
Tsuzuki, K, Hinohira, Y, Takebayashi, H, Kojima, Y, Yukitatsu, Y, Daimon, T et al. Novel endoscopic scoring system after sinus surgery. Auris Nasus Larynx 2014;4:450–4CrossRefGoogle Scholar
Lund, VJ, Mackay, IS. Staging in rhinosinusitis. Rhinol 1993;31:183–4Google Scholar
Oka, H, Tsuzuki, K, Takebayashi, H, Kojima, Y, Daimon, T, Sakagami, M. Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis. Auris Nasus Larynx 2013;40:452–7CrossRefGoogle ScholarPubMed
Tsuzuki, K, Hashimoto, K, Okazaki, K, Nishikawa, H, Sakagami, M. Predictors of disease progression after endoscopic sinus surgery in patients with chronic rhinosinusitis. J Laryngol Otol 2019;133:678–84CrossRefGoogle ScholarPubMed
Saito, T, Tsuzuki, K, Yukitatsu, Y, Sakagami, M. Correlation between olfactory acuity and sinonasal radiological findings in adult patients with chronic rhinosinusitis. Auris Nasus Larynx 2016;43:422–8CrossRefGoogle ScholarPubMed
Tsuzuki, K, Hashimoto, K, Okazaki, K, Sakagami, M. Post-operative course prediction during endoscopic sinus surgery in patients with chronic rhinosinusitis. J Laryngol Otol 2018;132:408–17CrossRefGoogle ScholarPubMed
Ishitoya, J, Sakuma, Y, Tsukuda, M. Eosinophilic chronic rhinosinusitis in Japan. Allergol Int 2010;59:239–45CrossRefGoogle ScholarPubMed
Sakuma, Y, Ishitoya, J, Komatsu, M, Shiono, O, Hirama, M, Yamashita, Y et al. New clinical diagnostic criteria for eosinophilic chronic rhinosinusitis. Auris Nasus Larynx 2011;38:583–8CrossRefGoogle ScholarPubMed
Ikeda, K, Sakurada, T, Suzaki, Y, Takasaka, T. Efficacy of systemic corticosteroid treatment for anosmia with nasal and paranasal sinus disease. Rhinology 1995;33:162–5Google ScholarPubMed
Stjärne, P, Mösges, R, Jorissen, M, Passàli, D, Bellussi, L, Staudinger, H et al. A randomized controlled trial of mometasone furoate nasal spray for the treatment of nasal polyposis. Arch Otolaryngol Head Neck Surg 2006;132:179–85CrossRefGoogle ScholarPubMed
Yukitatsu, Y, Hata, M, Yamanegi, K, Yamada, N, Ohyama, H, Nakasho, K et al. Decreased expression of VE-cadherin and claudin-5 and increased phosphorylation of VE-cadherin in vascular endothelium in nasal polyps. Cell Tissue Res 2013;352: 647–57CrossRefGoogle ScholarPubMed
Barnes, PJ. Glucocorticoids. Chem Immunol Allergy 2014;100:311–6CrossRefGoogle ScholarPubMed
Kobayashi, Y, Yasuba, H, Asako, M, Yamamoto, T, Takano, H, Tomoda, K. HFA-BDP Metered-Dose inhaler exhaled through the nose improves eosinophilic chronic rhinosinusitis with bronchial asthma: a blinded, placebo-controlled study. Front Immunol 2018;9:2192CrossRefGoogle ScholarPubMed
Kanda, A, Kobayashi, Y, Asako, M, Tomoda, K, Kawauchi, K, Iwai, H. Regulation of interaction between the upper and lower airways in united airway disease. Med Sci (Basel) 2019;7:27Google ScholarPubMed
Adcock, IM, Barnes, PJ. Molecular mechanisms of corticosteroid resistance. Chest 2008;134:394401CrossRefGoogle ScholarPubMed
Bachert, C, Mannent, L, Naclerio, RM, Mullol, J, Ferguson, BJ, Gevaert, P. Effect of subcutaneous dupilumab on nasal polyp burden in patients with chronic sinusitis and nasal polyposis: a randomized clinical trial. JAMA 2016;315:469–79CrossRefGoogle ScholarPubMed
Bachert, C, Han, JK, Desrosiers, M, Hellings, PW, Amin, N, Lee, SE et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet 2019;394:1638–50CrossRefGoogle ScholarPubMed