2016 Section 5 Green Book

Post-FESS long-term macrolide therapy for NP

FIGURE 1. Study flowchart.

(3 months), respectively. On the 7th day after surgery, all patients began maintenance therapy with mometasone furoate nasal spray (Nasonex, MSD, Merck & Co., Inc., NJ, USA) 400 μ g/day for a full 6 months, including group 3 (control no antibiotics) patients. The Ethics Committee approved the final study protocol with all enrolled 66 pa- tients signing consent forms. Patients were carefully followed and seen at 6 weeks, 12 weeks, and 24 weeks after FESS (Fig. 1). Results of treatment were based on evaluation of the following tests. 20-item SinoNasal Outcome Test (SNOT-20) The 20-item SinoNasal Outcome Test (SNOT-20) is a ques- tionnaire for evaluating the quality of life (QoL) in rhinos- inusitis patients. 11 Visual analogue scale The disease severity was assessed by the patients’ subjective evaluation on the 10-cm visual analogue scale (VAS); 1 cm on the scale reflected 1 point of the patient’s assessment; 0 to 3 points corresponded to mild disease, 3 to 7 points corresponded to moderate disease, and 7 to 10 points cor- responded to severe disease. Olfactory test The “Sniffin Sticks test,” extended version (Burghart Messtechnik GmbH, Wedel, Germany) was used for each

patient. 12 Odor identification was assessed by means of 16 test tubes with different odors. The number of correct an- swers was related to the degree of olfactory disturbance, with 16 being the maximum score possible. A score from 0 to 6 reflects anosmia, a score from 7 to 12 is termed hy- posmia, whereas a score ranging from 13 to 16 is normal. Saccharin transit time test This test measures the transit time for a saccharin particle to pass from the anterior head of the inferior nasal turbinate to the pharynx when the patient first experiences the sensation of a sweet taste. Nasal endoscopy Endoscopy was performed with a rigid 2.7-mm endoscope (Karl Storz, Tutlingen, Germany) without decongestion. Semiquantitative scores were recorded for polyps, edema, discharge, crusting, and scarring at baseline, 6 weeks, 12 weeks, and at the final assessment 24 weeks after FESS. These results were evaluated using an endoscopic appear- ance score (EAS). 4,13 Polyps were graded by size from 0 to 3 points; an absence of polyps was scored as 0, polyps appearing only in middle meatus were scored as 1; polyps extending beyond the middle meatus but not obstructing the nose were scored a 2; and polyps completely obstruct- ing the nose were scored a 3. Discharge was scored as follows: 0 = no discharge; 1 = clear, thin discharge; and

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