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International consensus statement on rhinosinusitis

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TABLE IX-28 Evidence for CRSsNP management with oral corticosteroids Study Year Study Design LOE Study Groups Clinical Endpoint Conclusions Poetker 1091 2013 Systematic review 2 4 level 4 studies involving oral corticosteroid use in CRSsNP patients. Subjective and objective improvements in CRSsNP patients from oral corticosteroids. Balance of benefit to harm and oral corticosteroids are an option for CRSsNP patients. Lal 1093 2011 Systematic Review 2 30 studies involving oral corticosteroid use in CRSsNP patients. Very little data given the widespread use. More research is needed to measure outcomes of corticosteroid use in CRSsNP patients. Liu 1090 2018 Case Series, retrospective

improvement that surgery was not required.

of corticosteroid group, 40% of the combo group had improved LM scores.

All had improved symptoms of varying degrees.

“successfully” treated, defined as complete

resolution of symptoms

40 of 100 required surgery. 35% had nasal polyps.

37.5% reported sufficient

53% of antibiotic group, 46%

Persistent symptoms 55% of patients were

Visual analog scale of sinus symptoms

before and 3 months after onset of therapy.

CT Lund-Mackay score Nasal symptoms Need for surgery

4 Antibiotics, mean 19 days N =

17 Methylprednisolone for 6 days OR prednisone for 20 days.;N = 28; both

antibiotics and oral steroids N = 55

4 Prednisone 30, 20, 10 mg for 7 days each and oral antibiotics (roxithromycin

or doxycycline) for 21 days.

4 Prednisone 60, 40, 20, 10 mg for 3 days each in

conjunction with 4 weeks of oral antibiotic, INCS, nasal saline rinses, topical nasal

decongestant spray (5 days on, 3 days off).

retrospective

retrospective

Lal 1094 2009 Case series,

Young 1092 2012 Case series,