xRead - Nasal Obstruction (September 2024) Full Articles

20426984, 2021, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22741 by Stanford University, Wiley Online Library on [01/07/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

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International consensus statement on rhinosinusitis

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test, nasal congestion, eosinophil count in polyp tissue,

exhaled nasal nitric oxide, and polyp size at week 2 and 12.

CT scan showed lower score at week 12

compared to baseline.

Improvement of nasal symptoms in steroid

arm. At 12 weeks, only hyposmia was

significantly different

between the 2 groups, favoring the steroid group. Objective

measures in steroid

arm, polyp size and

nasal patency, were improved and

maintained throughout the 12 weeks.

improvements in VAS,

Butanol threshold tests, PNIF in study group.

Improvement in smell

Statistically significant

protocol Clinical Endpoint Conclusions

Smell test (Barcelona Smell Test 24)

Nasal congestion (Likert scale)

Nasal polyp biopsy at week 0 and week 2. Nasal nitric oxide

(chemiluminescence) Polyp size (Lildholdt score)

Nasal symptoms (Likert scale)

Mometasone furoate nasal spray 200 μ g twice daily Nasal patency by nasal PEFI

Endoscopic grading of polyp size

CT scan (Lund-Mackay) Butanol olfactory threshold test

Peak nasal inspiratory flow

CT scan (Lund-Mackay)

Endoscopic polyp score

Visual analog scale.

Prednisone 30 mg daily for 4 days followed by 5 mg reductions every 2 days for a total of 2 weeks.

Prednisolone 60 mg for 7 days, then tapering every other day.

Prednisolone 50 mg daily

Systemic steroid

budesonide 400 μ g

weeks and

intranasal

BID for 12 weeks.

No corticosteroid treatment for 2 weeks.

Oral steroids for 17days

Oral steroids for 14 days plus

intranasal steroid

spray for 10 weeks Placebo plus

intranasal steroid

spray for 10 weeks

CRSwNP Study Group(s)

Alobid 1356 2014 2 RCT EPOS2007N = 92 Oral steroids for 2

visualization of polyps. N = 22

visualization of polyps N = 117

Ecevit 1616 2015 2 RCT Clinical exam and endoscopic

Clinical diagnosis and endoscopic

Definition of

Kirtsreesakul 1617 2012 2 RCT, double blinded

TABLE X-21 Evidence for CRSwNP management with oral corticosteroids Study Year LOE Study Design