Clin Exp Otorhinolaryngol.  2017 Mar;10(1):91-96. 10.21053/ceo.2016.00220.

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

• Kang TW
• Chung JH
• Cho SH
• Lee SH
• Kim KR
• Jeong JH

• KMID: 2376414
• DOI: http://doi.org/10.21053/ceo.2016.00220

Abstract

OBJECTIVES
Budesonide nasal irrigation was introduced recently for postoperative management of patients with chronic rhinosinusitis. The safety and therapeutic effectiveness of this procedure is becoming accepted by many physicians. The objective of this study was to evaluate the efficacy of postoperative steroid irrigation in patients with chronic rhinosinusitis and asthma.
METHODS
This prospective study involved 12 chronic rhinosinusitis patients with nasal polyps and asthma who received oral steroid treatment for recurring or worsening disease. The 22-item Sinonasal Outcomes Test (SNOT-22) and Lund-Kennedy endoscopy scores were checked before nasal budesonide irrigation, and 1, 2, 4, and 6 months after irrigation. We also calculated the total amount of oral steroids and inhaled steroids in the 6 months before irrigation and the 6 months after it.
RESULTS
The mean SNOT-22 score improved from 30.8±14.4 before irrigation to 14.2±8.7 after 6 months of irrigation (P=0.030). The endoscopy score also improved from 7.4±4.7 before irrigation to 2.2±2.7 after 6 months (P<0.001). The total amount of oral steroid was decreased from 397.8±97.6 mg over the 6 months before irrigation to 72.7±99.7 mg over the 6 months after irrigation (P<0.001).
CONCLUSION
Nasal irrigation with budesonide is an effective postoperative treatment for chronic rhinosinusitis with asthma, which recurs frequently, reducing the oral steroid intake.

Keyword

Nasal Lavage; Budesonide; Sinusitis; Asthma; Nasal Polyp

MeSH Terms

Asthma*
Budesonide*
Endoscopy
Humans
Nasal Lavage*
Nasal Polyps
Prospective Studies
Sinusitis
Steroids
Budesonide
Steroids

Figure

• 

  Fig. 1. Comparison of 22-item Sinonasal Outcomes Test (SNOT-22) scores before and after budesonide nasal irrigation. The mean SNOT-22 score (black circles and bold line) was significantly lower at each follow-up than before the irrigation (P-value=0.030). Black bold circle mean of patients.

• 

  Fig. 2. Comparison of Lund-Kennedy endoscopy (LK) scores before and after budesonide nasal irrigation. The mean LK score (black circles and bold line) was significantly lower at each follow-up than before the irrigation (P-value<0.001). Black bold circle mean of patients.

• 

  Fig. 3. Comparison of total amounts of oral steroid before and after budesonide nasal irrigation. (A) Average amounts of total oral steroid (P-value<0.001). (B) Total amounts of oral steroid used by each patient. Six patients took no systemic steroid after budesonide irrigation, and the other 6 patients used less steroid after the irrigation.

• 

  Fig. 4. Comparison of total amounts of steroid inhaled for asthma before budesonide nasal irrigation and after. They showed no significant difference between each other (P=0.198).

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