Comparison of Efficacy of Mometasone Furoate versus Clarithromycin in the Treatment of Chronic Rhinosinusitis without Nasal Polyps in Chinese Adults

2011 ◽  
Vol 25 (6) ◽  
pp. e203-e207 ◽  
Author(s):  
Ming Zeng ◽  
Xiao-Bo Long ◽  
Yong-Hua Cui ◽  
Zheng Liu
Keyword(s):  
Chronic Rhinosinusitis ◽  
Clinical Efficacy ◽  
Nasal Polyps ◽  
Observation Time ◽  
Mometasone Furoate ◽  
Nasal Discharge ◽  
Chinese Adults ◽  
Open Label ◽  
Significant Difference ◽  
Physical Findings

Background Although both nasal steroids and macrolide antibiotics have been recommended for the treatment of chronic rhinosinusitis without nasal polyps (CRSsNPs), whether there is any difference in their clinical efficacy remains unexplored. In addition, few studies have investigated their clinical efficacy in a Chinese population living in China, who present distinct inflammatory patterns compared with white patients in western countries. This study compares the efficacy of mometasone furoate and clarithromycin treatment in CRSsNP in Chinese adults in a preliminary prospective, open-label, randomized trial. Methods Forty-three CRSsNP patients were randomized to receive mometasone furoate nasal spray at 200 μg (n = 21) or clarithromycin tablet at 250 mg (n = 22) once daily for 12 weeks. Patients were assessed before the treatment and after 4, 8, and 12 weeks after treatment. Subjective symptoms were scored on a visual analog scale. Endoscopy physical findings were scored according to Lanza-Kennedy scoring system. Moreover, smoking and atopic status and coexistence of allergic rhinitis (AR) and asthma were recorded. Results Before the treatment, no significant difference in symptoms and nasal endoscopic physical findings were found between mometasone furoate and clarithromycin group. As early as 4 weeks after dosing, a significant reduction of total symptom scores, nasal obstruction, headache, rhinorrhea and overall burden scores, and mucosal swelling and nasal discharge scores were observed in both groups. No significant difference in symptom or endoscopic scores was observed between these two groups at any posttreatment observation time point. The coexistence of AR was correlated with lower scores of mucosal edema and nasal secretion in the mometasone furoate group after 12-week treatment. Conclusion Mometasone furoate and clarithromycin show a comparable clinical effect for CRSsNPs in Chinese adults. Mometasone furoate is more effective in improving edema and secretion for CRSsNP patients with concomitant AR.

scholarly journals CLINICAL PROFILE OF CHRONIC RHINOSINUSITIS: A STUDY IN CENTRAL INDIA

2021 ◽  
pp. 104-106
Author(s):  
Tanvi Rekhade ◽  
A.Z. Nitnaware ◽  
Seema Patel ◽  
R.T. Pawar ◽  
Ashish Keche
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Nasal Septum ◽  
Nasal Polyps ◽  
Central India ◽  
Nasal Discharge ◽  
Deviated Nasal Septum ◽  
Northern India ◽  
Causative Factors

Chronic Rhinosinusitis (CRS) has heavy implications on the quality of life and has a prevalence of about 46.1 % in northern India with similar pattern across the country.This research has been undertaken to study the presentation and causative factors for CRS in central India. Data of 100 patients diagnosed as CRS was studied. Patients presented with nasal obstruction and nasal discharge at large. Nasal polyps were seen in 37% cases. The most common associated etiopathological factor was anatomical obstruction due to deviated nasal septum.

scholarly journals Immune Imbalance in Nasal Polyps of Caucasian Chronic Rhinosinusitis Patients Is Associated with a Downregulation of E-Selectin

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Michael Könnecke ◽  
Robert Böscke ◽  
Anja Waldmann ◽  
Karl-Ludwig Bruchhage ◽  
Robert Linke ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Essential Role ◽  
Expression Profiles ◽  
Inferior Turbinate ◽  
Significant Inhibition ◽  
Significant Difference ◽  
Mrna And Protein Expression ◽  
Immune Imbalance ◽  
Protein Expression Profiles

Chronic rhinosinusitis with nasal polyps (CRSwNP) in Caucasians is a chronic Th2 inflammatory disease of the nasal and paranasal mucosa and the recruitment of leukocytes to the site of inflammation is poorly understood. We studied mRNA and protein expression profiles of adhesion molecules in nasal polyp and associated inferior turbinate tissues using molecular, biochemical, and immunohistological methods. Analysis showed a strongly decreased E-selectin expression in nasal polyps with a significant difference between eosinophil and neutrophil counts in nasal polyps and balanced counts in inferior turbinates. E-selectin expression is known to be downregulated in a Th2 milieu and has an essential role in immunosurveillance by locally activating neutrophil arrest and migratory function. A downregulation of E-selectin may come along with an immune imbalance in Caucasian nasal polyps due to a significant inhibition of neutrophil recruitment. Therefore, we suggest that an upregulation of E-selectin and the associated influx of neutrophils may play a significant role in the resolution of inflammation as well as for the pathophysiology of nasal polyps of Caucasian chronic rhinosinusitis patients.

scholarly journals A comparative study of microdebrider assisted versus conventional endoscopic sinus surgery for nasal polyposis

2019 ◽  
Vol 5 (4) ◽  
pp. 1030
Author(s):  
Ranganath Kumar Datta ◽  
Ramya Bandadka ◽  
Lakshmi Priya Shelly
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Operative Time ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Recurrence Rates ◽  
Conventional Instruments ◽  
Number Of Patients ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> Nasal polyps are benign, chronic, inflammatory lesions arising from the mucosa of the nasal sinuses or from the mucosa of the nasal cavity. They are a challenge to treat due to their uncertain etiology and tendency to recur. Therapy involves both medical and surgical treatment. Surgical management includes Endoscopic sinus surgery using conventional instruments or by microdebrider.</p><p class="abstract"><strong>Methods:</strong> We conducted a study on 80 patients with nasal polyposis in whom conservative management failed. They were equally randomised into powered and conventional instruments Endoscopic Sinus Surgery (ESS) groups. The groups were compared for surgical outcomes, intra and postoperative complications and recurrence rates.  </p><p class="abstract"><strong>Results:</strong> Age of patients suffering from bilateral nasal polyposis ranged from 18 to 55 years with maximum number of patients in the group 31 to 40 years. Nasal polyps were more commonly seen in men (53.75%) than women (46.25%). Most common symptom experienced was nasal obstruction (100%), followed by olfactory disturbance in 88.7% and nasal discharge in 76.25%. There was statistically significant difference in operative time, blood loss and postoperative synechiae, with the microdebrider group showing better outcomes. There was no statistically significant difference in the postoperative VAS (visual analogue score) and recurrence rates between the two groups.</p><p class="abstract"><strong>Conclusions:</strong> Powered endoscopic sinus surgery offers a better therapeutic approach for patients with nasal polyposis than with conventional instruments. It provides bloodless operative field with better visualisation for a more precise, less traumatic procedure with shorter operative time.</p>

scholarly journals Postsurgical rehabilitation of patients with chronic rhinosinusitis

2020 ◽  
pp. 74-79
Author(s):  
Sergey B. Bezshapochny ◽  
Valery V. Loburets ◽  
Andrey V. Loburets ◽  
O.R. Dzhirov
Keyword(s):  
Chronic Rhinosinusitis ◽  
Postoperative Period ◽  
Healing Process ◽  
Functional Anatomy ◽  
Endoscopic Examination ◽  
Nasal Discharge ◽  
Significant Difference ◽  
Clinical Advantage ◽  
Endoscopic Score ◽  
Based Medicine

Topicality: Modern rhinosurgery in tht treatment of chronic rhinosinusitis based of tht principles of maximum preservation of the functional anatomy of the nasal cavity. This helps to improve not only the healing process but also tht quality of life of the patient. Functional endoscopic surgery (FESS) is tht most effective treatment lor chronic rhinosinusitis today. This method helps to accelerate the recovery of patients and reduce the number of postoperative complications, which in turn reduces the need lor surgery. But apart from meticulous and careful surgical technique, one of the most important places in the treatment of the patient is optimal management after surgery, for maximum potentiating of recovery. The relevance of the study is due to the need to further improve the pharmacotherapy of the postoperative period. This article high lights several different therapies aimed at the fast test restoration of the physiological work of the nasal structures. Materials and methods: In total, 50 patients were divided into three groups as part of the study. Group 1 received an isotonic solution of 0.9% NaCl from day one and topical glucocorticosteroids (Mometasone furoate) from day 7. In group 2A, phytopreparation was added to classic therapy and 0.9% NaCl was used instead of the standard saline solution, with 0.4% CO2 added. Evaluation of the effectiveness of treatment was performed using a visual-analog scale lor subjective symptoms and endoscopic examination using the scale of The Modified Lund-Kennedy Endoscopic Score lor objective symptoms. Results: On the 7th day, statistically significant differences were observed according to VAS data between patients of the 1st and 2B groups in terms of nasal discharge (p<0.05, U=77.5) and impaired olfactory function (p<0.05, U=75), in the same period a statistically significant difference was observed between MLK indices in patients of 1st and 2B groups (p<0.05, at U=73) No side effects of the drugs used in the study were detected. Conclusion: Based on the study, it can be concluded tht the use in the postoperative period of the proposed drugs have a significant clinical advantage, which is based of clinical studies and confirmed by the principles of evidence-based medicine.

scholarly journals Diagnostic and treatment algorithm for different phenotypes of chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 16 (2) ◽  
pp. 50-60 ◽  
Author(s):  
E L Savlevich ◽  
M E Dyneva ◽  
L E Gaganov ◽  
V I Egorov ◽  
A N Gerasimov ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Treatment Algorithm ◽  
Clinical Manifestations ◽  
Diagnostic Biomarkers ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Asthma Group

Chronic rhinosinusitis with nasal polyps (CRSwNP) may vary in clinical manifestations and can often be associated with a number of comorbid diseases. For a practitioner it is important to forecast the development of the disease, evaluate the risk of relapse and select the most efficient method of treatment in each clinical case. At present, there are no standardized and validated diagnostic biomarkers that could be used as predictors of CRSwNP clinical course. Purpose of the study: to develop diagnostic and treatment algorithm for varies CRSwNP phenotypes based on clinical and laboratory parameters. Materials and methods, CRSwNP patients were split into 3 groups: group 1 - CRSwNP without allergy and asthma; group 2 - CRSwNP with allergic rhinitis and/or allergic asthma; group 3 - CRSwNP with non-allergic asthma. All patients were subjected to nasal cavity endoscopy and nasal polyps biopsy, allergological examination, histological analysis of polyp stroma to detect the leukocytes infiltration and eosinophil-neutrophil index (ENI). Results, CRSwNP phenotypes show significant difference in clinical manifestations of rhinosinusitis (p

scholarly journals The role of bacteriotherapy in the restoration of the nasal mucosa in patients with chronic rhinosinusitis

2021 ◽  
pp. 62-67
Author(s):  
Alexander N. Naumenko ◽  
Ahmad Abdelrazzaq Moh’dabdel razzaq ◽  
Margaryta R. Amirkhanova
Keyword(s):  
Topical Corticosteroid ◽  
Chronic Rhinosinusitis ◽  
Nasal Spray ◽  
Nasal Mucosa ◽  
Mometasone Furoate ◽  
Streptococcus Salivarius ◽  
Saline Irrigation ◽  
Significant Difference ◽  
Snot 22

Topicality: Chronic rhinosinusitis is an polyetiological disease with shch basic complaints as nasal obstruction, nasal discharge, headache or facial pain and reduction of smell. The SNOT-22 questionnaire is widely used to detail patient complaints in various fields. Chronic rhinosinusitis is most often divided into chronic rhinosinusitis with polyps and without nasal polyps. Given the large number of phenotypes and endotypes of the disease, it is important to study further the mechanisms of pathogenesis and selec- tion of individualized treatment. Aim: to determine the role of topical application of Streptococcus salivarius 24SMBc and Streptococcus orals 89a in the form of nasal spray in improving the condition of the nasal mucosa in chronic rhinosinusitis and reducing the recurrence rate. Materials and methods: The study was conducted at the Department of Otolaryngology of National Medical University on the basis of KNP "Oleksandrivs’ka Clinical Hospital of Kyiv". It was attended by 82 patients (38 women and 44 men) aged 18 to 60 years, who were randomly divided into two groups. The 1st group (main, 43 patients) received treatment: irrigation therapy with isotonic saline, topical corticosteroid mometasone furoate in combination with a nasal spray, which contains autochthonous saprophytes (AC) – Streptococcus salivarius 89SMBc and Streptococcus orals 89a nasal mucus. The 2nd group (control, 39 patients) received nasal saline irrigation therapy, topical corticosteroid mometasone furoate in combination with topical antibiotic framicetin sulfate. Assessment was performed according to the VAS scale, SNOT-22 questionnaire (before treatment, on the 10th day of treatment and one month after the end of therapy) and determining the frequency of relapses in patients of both groups. Results: According to the obtained results, the indicators of patients of both groups before treatment and on the 10th day had no statistically significant difference (p>0.05). However a month later patients in the main group had better results (p<0.05) on the scale of VAS and the SNOT-22 questionnaire. So, topical use of Streptococcus salivarius 24SMBc and Streptococcus orals 89a as a nasal spray is effective and can be recommended for the treatment of patients with chronic rhinosinusitis in the acute stage.

Efficacy of Dexamethasone Versus Fluticasone Nasal Sprays in Postoperative Patients With Chronic Rhinosinusitis With Nasal Polyps

2019 ◽  
Vol 33 (5) ◽  
pp. 478-482 ◽  
Author(s):  
Kristin A. Seiberling ◽  
Stephanie C. Kidd ◽  
Grace H. Kim ◽  
Christopher A. Church
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Standard Dose ◽  
Controlled Trial ◽  
Sinus Surgery ◽  
Double Blind ◽  
Nasal Sprays ◽  
Significant Difference ◽  
Nasal Steroid ◽  
Snot 22

Background Topical nasal steroids are commonly prescribed to patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) following endoscopic sinus surgery (ESS). They are found to be effective in improving symptoms and quality of life as well as reducing the incidence of nasal polyps recurrence. Objective We sought to determine whether a higher concentration of topical nasal steroid spray is more effective than the standard nasal steroid spray in controlling symptoms and preventing recurrence of polyps in patients with CRSwNP who underwent ESS. Method A double-blind randomized controlled trial was performed on patients with CRSwNP after ESS. Patients were randomized into 2 treatment groups: one received topical nasal dexamethasone 0.032% and the other, fluticasone proprionate. The 22-item Sino-Nasal Outcome Test (SNOT-22) and Lund-Kennedy nasal endoscopy scores were measured at the initiation of topical nasal steroid treatment and then at approximately 4-, 8-, and 12-week intervals. Results Thirty-nine patients were enrolled in the study. Eighteen patients continued using the medications prescribed to them for the duration of the study. There were 8 patients in the dexamethasone group and 10 patients in the fluticasone group. Both groups saw significant improvements in postoperative SNOT-22 and Lund-Kenney scores over time. There was no significant difference in improvement between the groups. Conclusion There is no significant increased benefit in using a higher dose nasal steroid spray compared to the standard dose nasal steroid spray after ESS.

scholarly journals Postoperative Management of Eosinophilic Chronic Rhinosinusitis with Nasal Polyps: Impact of High-Dose Corticosteroid Nasal Spray

2018 ◽  
Vol 23 (01) ◽  
pp. 101-103 ◽  
Author(s):  
Katsuhisa Ikeda ◽  
Shin Ito ◽  
Remi Hibiya ◽  
Hirotomo Homma ◽  
Noritsugu Ono ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Mometasone Furoate ◽  
Sinus Surgery ◽  
High Dose ◽  
Double Dose ◽  
Normal Ranges ◽  
Long Term Treatment ◽  
Eosinophilic Chronic Rhinosinusitis

Introduction Eosinophilic chronic rhinosinusitis (ECRS) is characterized by an eosinophilic inflammation driven by Th2-type cytokines. Glucocorticosteroids are the most common first-line treatment for ECRS with nasal polyps. Objective We have evaluated the long-term treatment with double-dose intranasal corticosteroids in refractory ECRS nasal polyps resistant to the conventional dose and assessed the risk of adverse systemic effects Methods Sixteen subjects were enrolled in this study. All subjects had ECRS after endoscopic sinus surgery that resulted in recurrent mild and moderate nasal polyps and were undergoing a postoperative follow-up application of mometasone furoate at a dose of 2 sprays (100 μg) in each nostril once a day (200 μg). All the patients were prescribed mometasone furoate, administered at a dose of 2 sprays (100 μg) in each nostril twice a day (400 μg) for 6 months. Results The average scores of the symptoms during the regular dose of intranasal steroid treatment were 5.2 ± 2.2, but 6 months after the high-dose application, they had significantly decreased to 2.5 ± 1.4 (p < 0.05). The polyp size showed an average score of 1.38 during the regular dose which was significantly reduced to 0.43 (p < 0.01) by the double dose. Glycated hemoglobin (HbA1c) showed normal ranges in all the patients tested. The cortisol plasma concentration was also normal. Conclusion Doubling the dose of the nasal topical spray mometasone furoate might be recommended for the treatment of recurrent nasal polyps in the postoperative follow-up of intractable ECRS.

scholarly journals Correlations between symptoms, nasal endoscopy and computed tomography findings in patients with chronic rhinosinusitis without nasal polyps

2020 ◽  
Vol 77 (1) ◽  
pp. 41-46
Author(s):  
Slobodan Savovic ◽  
Natasa Dragnic ◽  
Vladimir Kljajic ◽  
Ljiljana Jovancevic ◽  
Maja Buljcik-Cupic ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Facial Pain ◽  
Nasal Polyps ◽  
Nasal Congestion ◽  
Endoscopic Examination ◽  
Nasal Endoscopy ◽  
Nasal Discharge ◽  
Strongly Correlated ◽  
Moderate Correlation ◽  
Severity Of The Disease

Background/Aim. Chronic rhinosinusitis (CRS) is one of the most common chronic conditions that is diagnosed on the basis of the condition symptoms, nasal endoscopy and computed tomograhpy (CT) of the nose and paranasal sinuses. There are two forms of CRS: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). The aim of this paper was to determine if there is a correlation between the symptoms, nasal endoscopy and CT in patients with CRSsNP. Methods. The study included 110 patients with CRSsNP. The intensity of the symptoms assessed on the visual analogue scale (VAS) and the condition of nasal mucosa and the presence of nasal secretion was estimated by endoscopic examination of the nose while CT was used to determine the Lund-Mackay (LM) score values. Pearson?s coefficient of correlation was used for statistic data processing. Results. The severity of the disease as a whole (r = 0.509) and nasal discharge (r = 0.562) moderately correlated with CT. Nasal congestion (r = 0.354) and the reduction of loss of smell (r = 0.324) mildly correlated with CT, while facial pain/pressure (r = 0.218) had a very weak correlation with CT. The severity of the disease as a whole (r = 0.717) and nasal discharge (r = 0.821) strongly correlated with nasal endoscopy. Nasal congestion (r = 0.525) had a moderate correlation with nasal endoscopy while facial pain/pressure (r = 0.345) and the reduction of the loss of smell (r= 0.394) had a mild correlation with nasal endoscopy. A moderate correlation was found between nasal endoscopy and CT (r = 0.630). Conclusion. The severity of the disease as a whole and nasal discharge have more significant correlations both with nasal endoscopy and CT in relation to the correlations between other symptoms and nasal endoscopy, as well as CT. More significant correlations between the symptoms and nasal endoscopy in relation to the correlations between the symptoms and CT and the existence of a moderate correlation between nasal endoscopy and CT, enable a lesser use of CT diagnostics and only in precisely defined situatiations.

Sign in / Sign up

Export Citation Format

Share Document