The effects of nasal lavage with betamethasone cream post-endoscopic sinus surgery: clinical trial

2017 ◽  
Vol 132 (2) ◽  
pp. 143-149 ◽  
Author(s):  
B Dawson ◽  
I Gutteridge ◽  
A Cervin ◽  
D Robinson
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Safety Data ◽  
Serum Cortisol ◽  
Urinary Free Cortisol ◽  
Sinus Surgery ◽  
Nasal Irrigation ◽  
Free Cortisol ◽  
Cortisol Levels ◽  
The Impact

AbstractBackground:Steroid nasal irrigation for chronic rhinosinusitis patients following endoscopic sinus surgery reduces symptom recurrence. There are minimal safety data to recommend this treatment. This study evaluated the safety of betamethasone nasal irrigation by measuring its impact on endogenous cortisol levels.Methods:Participants performed daily betamethasone nasal irrigation for six weeks. The impact on pre- and post-intervention serum and 24-hour urinary free cortisol was assessed. Efficacy was evaluated using the 22-item Sino-Nasal Outcome Test.Results:Thirty participants completed the study (16 females and 14 males; mean age = 53.9 ± 15.6 years). Serum cortisol levels were unchanged (p = 0.28). However, 24-hour urinary free cortisol levels decreased (47.5 vs 41.5 nmol per 24 hours; p = 0.025). Sino-Nasal Outcome Test scores improved (41.13 ± 21.94 vs 23.4 ± 18.17; p < 0.001). The minimal clinical important difference was reached in 63 per cent of participants.Conclusion:Daily betamethasone nasal irrigation is an efficacious treatment modality not associated with changes in morning serum cortisol levels. The changes in 24-hour urinary free cortisol levels are considered clinically negligible. Hence, continued use of betamethasone nasal irrigation remains a viable and safe treatment option for chronic rhinosinusitis patients following functional endoscopic sinus surgery.

scholarly journals The Effectiveness of Budesonide Nasal Irrigation After Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Asthma

2017 ◽  
Vol 10 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Tae Wook Kang ◽  
Jae Ho Chung ◽  
Seok Hyun Cho ◽  
Seung Hwan Lee ◽  
Kyung Rae Kim ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Nasal Irrigation

scholarly journals Bilateral and unilateral adrenal incidentalomas: biochemical and clinical characteristics

2013 ◽  
Vol 168 (2) ◽  
pp. 235-241 ◽  
Author(s):  
V Morelli ◽  
S Palmieri ◽  
A S Salcuni ◽  
C Eller-Vainicher ◽  
E Cairoli ◽  
...  
Keyword(s):  
Serum Cortisol ◽  
Urinary Free Cortisol ◽  
Adrenal Incidentalomas ◽  
Mineral Density ◽  
Femoral Bone Mineral Density ◽  
Free Cortisol ◽  
Suppression Test ◽  
Cortisol Levels ◽  
Dexamethasone Suppression

ObjectiveThe possible different prevalence of arterial hypertension (AH), type 2 diabetes mellitus (T2DM), dyslipidaemia (DL) and vertebral fractures (FX) between patients with bilateral and unilateral adrenal incidentalomas (BAI and UAI, respectively) with and without subclinical hypercortisolism (SH) is unknown. In this study we compared the prevalence of AH, T2DM, DL and FX in BAI and UAI patients in relation to SH.DesignProspective study.MethodsIn 175 UAI and 38 BAI patients, we evaluated BMI, spinal and femoral bone mineral density (LS and FN BMD, respectively) and the presence of AH, T2DM, DL and FX. SH was diagnosed in the presence of ≥2 of the following: urinary free cortisol levels >193 nmol/24 h, serum cortisol levels after 1 mg dexamethasone suppression test >83 nmol/l or ACTH levels <2.2 pmol/l.ResultsAge, BMI and cortisol secretion were comparable, while FN BMD was lower in BAI than in UAI patients (−0.45±0.86 vs 0.09±1.07, P=0.004). The prevalence of SH, AH, T2DM, and DL was comparable, while the prevalence of FX was higher in BAI than in UAI (52.6 vs 28%, P=0.007). The presence of FX was associated with BAI (odds ratio (OR) 2.6, 95% confidence interval (95% CI) 1.2–5.6, P=0.016), after adjusting for SH (OR 1.77, 95% CI 0.85–3.7, P=0.12), BMI (OR 1.06, 95% CI 0.98–1.13, P=0.1), age (OR 1.07, 95% CI 1.04–1.11, P=0.0001) and LS BMD (OR 1.31, 95% CI 1.03–1.67, P=0.03).ConclusionBAI patients have an increased FX risk than UAI ones. Further studies should investigate the causes of bone involvement in BAI patients.

The effects of nasal irrigation with various solutions after endoscopic sinus surgery: systematic review and meta-analysis

2018 ◽  
Vol 132 (8) ◽  
pp. 673-679 ◽  
Author(s):  
X Z Chen ◽  
S Y Feng ◽  
L H Chang ◽  
X P Lai ◽  
X H Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Rhinosinusitis ◽  
Normal Saline ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Cochrane Central Register ◽  
Nasal Irrigation ◽  
Symptom Scores

AbstractBackgroundNasal irrigation is commonly performed in patients with chronic rhinosinusitis after functional endoscopic sinus surgery. This study systematically assessed the clinical efficacy of nasal irrigation from the medical literature.MethodsThe PubMed, Embase and Cochrane Central Register of Controlled Trials databases were searched using a comprehensive strategy, limited to English-language articles, published from October 1971 to March 2017, and comprising human subjects.ResultsA total of 824 trials were identified, 5 of which, involving 331 participants, were included in this systematic review. After selection, only three trials were eligible for inclusion in a meta-analysis. Nasal irrigation using normal saline and various solutions was found to be effective in reducing symptom scores and endoscopic scores for chronic rhinosinusitis patients after functional endoscopic sinus surgery. Comparison of outcome measures, such as eosinophil count reduction, revealed that various solutions are more effective than normal saline alone; however, no statistical significance was found in terms of reduced symptom or endoscopic scores.ConclusionBased on the current limited evidence, nasal irrigation is an effective therapy for chronic rhinosinusitis patients after functional endoscopic sinus surgery. However, when comparing various solutions with normal saline, no significant difference was found in symptom scores or endoscopic scores.

Comparison of Salivary Cortisol, Serum Cortisol, Plasma ACTH and Urinary Free Cortisol Levels in Thyrotoxic and Hypothyroid Patients

2012 ◽  
Vol 32 (1) ◽  
pp. 54-58
Author(s):  
Mustafa Sait GÖNEN ◽  
Emin ÖZKAYA ◽  
Sevil KURBAN ◽  
Süleyman Hilmi İPEKCİ ◽  
Cevdet DURAN ◽  
...  
Keyword(s):  
Salivary Cortisol ◽  
Serum Cortisol ◽  
Urinary Free Cortisol ◽  
Plasma Acth ◽  
Free Cortisol ◽  
Cortisol Levels ◽  
Hypothyroid Patients

scholarly journals The impact of zinc supplementation on the outcome of endoscopic sinus surgery and ciliary function of the nasal mucosa in children with chronic rhinosinusitis

2021 ◽  
pp. 73-82
Author(s):  
С.И. Алексеенко ◽  
А.В. Скальный ◽  
С.А. Карпищенко ◽  
С.А. Артюшкин ◽  
С.В. Барашкова ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Mucosa ◽  
Endoscopic Sinus Surgery ◽  
Inductively Coupled Plasma ◽  
Beat Frequency ◽  
Ciliary Beat Frequency ◽  
Sinus Surgery ◽  
Ciliary Activity ◽  
Ciliary Function ◽  
The Impact

Несмотря на указания на роль цинка в функции реснитчатого эпителия, данные относительно влияния коррекции обмена цинка на цилиарную функцию у пациентов с хроническим риносинуситом отсутствуют. Целью настоящего исследования явилась оценка эффективности хирургического лечения, активности мукоцилиарного аппарата, а также местной воспалительной реакции слизистой оболочки носа в послеоперационном периоде у детей с хроническим риносинуситом на фоне применения цинка. Методы. Обследовано 192 ребенка с хроническим риносинуситом, в лечении которых применялась эндоскопическая риносинусохирургия. Из них 131 ребенок в послеоперационном периоде получал стандартные назначения, тогда как 61 ребенок дополнительно получал цинк в суточной дозе 10 мг в течение 90 дней. Оценка концентрации цинка в сыворотке крови осуществлялась методом ИСП-МС. Для определения функции цилий использована видеоцитоморфометрия. Определение эффективности лечения осуществлялось с использованием опросника SNOT-20, а также шкал Лунд-Кеннеди и Лунд-Маккей. Результаты. Проведение эндоскопической операции приводило к достоверному снижению значений шкал SNOT-20, Лунд-Кеннеди и Лунд-Маккей у пациентов вне зависимости от приема цинка. В то же время, пациенты, принимавшие цинк, характеризовались достоверно меньшим риском ревизионной хирургии. Цинк также оказывал значительное влияние на функционирование реснитчатого эпителия. В частности, к 12-му месяцу наблюдения количество клеток с подвижными цилиями, частота биения цилий, длина цилий и выживаемость клеток у пациентов, принимавших цинк, превышала соответствующие показатели в контрольной группе. Повышение уровня цинка в организме также сопровождалось многократным снижением количества инфильтрирующих слизистую оболочку нейтрофилов и лимфоцитов. Заключение. Предполагается, что цинк ускоряет репаративные процессы в слизистой оболочке носа и обладает противовоспалительным действием. Despite the presence of certain indications of the role of zinc in ciliated epithelium functioning, data on the potential effect of Zn supplementation in ciliary function in patients with chronic rhinosinusitis are absent. The aim of this study was to evaluate the efficiency of surgical treatment, ciliary activity, as well as local inflammation of nasal mucosa in children with chronic rhinosinusitis undergoing functional endoscopic surgery. Methods. 192 pediatric patients with chronic rhinosinusitis were examined. 131 patients received standard postoperative prescriptions, whereas 61 children received 10 mg Zn daily for 90 days. Serum Zn concentrations were measured by inductively coupled plasma mass spectrometry. Ciliary function was evaluated by video cytomorphometry. Surgery efficiency was assessed with a SNOT-20 questionnaire, as well as with Lund-Kennedy and Lund-Mackay scales. Results. Functional endoscopic sinus surgery resulted in a significant decrease in total SNOT-20, Lund-Kennedy, and Lund-Mackay scores independent of Zn supplementation. At the same time, Zn supplemented patients had a significantly lower risk of revision surgery. Zn also had a significant impact on ciliary function. Specifically, up to the 12th mo postoperatively, Zn supplementation resulted in higher number of cells with motile cilia, ciliary beat frequency, ciliary length, and cell viability as compared to controls. Increased Zn status was also associated with a manyfold decrease in mucosal neutrophil and lymphocyte infiltration. Conclusions. It is proposed that Zn enhances reparative processes in nasal mucosa and possesses anti-inflammatory activity.

Budesonide nasal irrigation improved Lund–Kennedy endoscopic score of chronic rhinosinusitis patients after endoscopic sinus surgery

2019 ◽  
Vol 276 (5) ◽  
pp. 1397-1403 ◽  
Author(s):  
Zi-zhen Huang ◽  
Xian-zhen Chen ◽  
Jian-cong Huang ◽  
Zhi-yuan Wang ◽  
Xia Li ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Nasal Irrigation ◽  
Endoscopic Score
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