Budesonide nasal irrigation improved Lund–Kennedy endoscopic score of chronic rhinosinusitis patients after endoscopic sinus surgery
Budesonide improves the prognosis of chronic rhinosinusitis (CRS). However, few reports have examined whether its use for nasal irrigation, compared to normal saline, improves the prognosis of patients after endoscopic sinus surgery (ESS). We compared the effects of nasal irrigation with budesonide and normal saline in CRS patients after ESS.
Sixty CRS patients who had undergone ESS were randomly divided into an experimental group (30 patients), which used budesonide nasal irrigation, and a control group (30 patients), which used normal saline nasal irrigation. All patients received regular follow-up evaluations and were assessed via questionnaires, including the Lund–Kennedy endoscopic score (LKES), the symptom visual analog scale (VAS), the 22-item Sino-Nasal Outcome Test (SNOT-22), the Short-Form 36-Item Questionnaire (SF-36), the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS) and a side effects scale.
Scores of polyposis, mucosal edema, secretions and total score of LKES; VAS scores of nasal blockage, hyposmia and rhinorrhea; and SNOT-22 results in both groups were significantly improved 3 months after ESS. Scores of polyposis, mucosal edema, secretions and scarring and total score of LKES in experimental group were significantly better than in control group 3 months after ESS. No significant differences were observed in SF-36, SAS or SDS before or 3 months after ESS within or between the two groups. The side effects of the two groups were not significantly different.
Nasal irrigation improved the prognosis of CRS patients after ESS. Budesonide nasal irrigation had a better effect than normal saline nasal irrigation.
KeywordsBudesonide Irrigation Chronic rhinosinusitis Prognosis Endoscopy
We thank Xi-fu Wu, Luo-ying Yang and Shuai-xiang Li for their help in collecting and processing clinical specimens.
This study was supported by the Program of the National Natural Science Foundation of China (NSFC 81371073, 81670913), the Science and Technology Planning Project of Tianhe District, Guangzhou, Guangdong Province, China (201409KW027), and Medical Scientific Research Foundation of Guangdong Province (A2015312).
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to declare.
- 1.Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F et al (2012) European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl 23:1–298Google Scholar
- 4.Blackwell DL, Lucas JW, Clarke TC (2014) Summary health statistics for US adults: National Health Interview Survey, 2012. National Center for Health Statistics. Vital Health Stat 10:1–161Google Scholar
- 7.Sahlstrand-Johnson P, Ohlsson B, Von Buchwald C, Jannert M, Ahlner-Elmqvist M (2011) A multi-centre study on quality of life and absenteeism in patients with CRS referred for endoscopic surgery. Rhinology 49:420–428Google Scholar
- 9.Chen XZ, Feng SY, Chang LH, Lai Xiaoping C, Xiaohong L Xia, et al. The effects of nasal irrigation with different solutions after endoscopic sinus surgery: a systematic review and meta-analysis. J Laryngol Otol 2018; 1–7Google Scholar
- 12.Bhalla RK, Payton K, Wright ED (2008) Safety of budesonide in saline sinonasal irrigations in the management of chronic rhinosinusitis with polyposis: lack of significant adrenal suppression. J Otolaryngol Head Neck Surg 37:821–825Google Scholar
- 15.Fokkens W, Lund V, Mullol J (2007) European position paper on rhinosinusitis and nasal polyps group. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists. Rhinology 45:97–101Google Scholar
- 19.Hyo N, Takano H, Hyo Y (1989) Particle deposition efficiency of therapeutic aerosols in the human maxillary sinus. Rhinology 27:17–26Google Scholar
- 24.Merkus P, Ebbens FA, Muller B, Fokkens WJ (2006) The ‘best method’ of topical nasal drug delivery: comparison of seven techniques. Rhinology 44:102–107Google Scholar