OBJECTIVE: The objective of this study was to determine whether aggressive medical therapy of gastroesophageal reflux disease (GERD) could improve both subjective and objective features of chronic resistant sinusitis (CRS). METHODS:Consecutive patients with CRS underwent assessment of GERD and sinus symptoms, esophageal motility testing, dual-channel esophageal pH testing, and laryngoscopy and nasal endoscopy at baseline. The results were compared to those of a group of GERD patients without sinus problems. The CRS patients alone then received omeprazole 20 mg b.i.d. for 3 months with symptom follow-up at monthly intervals. Laryngoscopy and nasal endoscopy were repeated at 3 months. RESULTS:Eleven patients with CRS and 19 GERD patients participated. Eight CRS patients experienced heartburn at least once weekly. Esophageal manometry and pH test results were similar between the two groups. Nine CRS patients had an abnormal pH test. All 11 CRS patients completed the 3-month course of omeprazole. Individual sinus symptoms (nasal congestion, nasal drainage, sinus pressure, facial headache, malaise) and global satisfaction were modestly improved in 25-89% and 91%, respectively, at 12 wk. Resolution of symptoms occurred infrequently. We identified no baseline variable that could predict symptom improvement. Although laryngoscopy and nasal endoscopy were abnormal in most CRS patients at baseline and improved in some after treatment, these changes did not parallel symptom improvement. CONCLUSION: In this small, prospective, open label study, we demonstrated a high prevalence of GERD in patients with CRS, many of whom experienced modest sinus symptom improvement after using omeprazole b.i.d. for 3 months. These findings warrant further randomized, controlled study in a larger patient population.
RCT Entities:
OBJECTIVE: The objective of this study was to determine whether aggressive medical therapy of gastroesophageal reflux disease (GERD) could improve both subjective and objective features of chronic resistant sinusitis (CRS). METHODS: Consecutive patients with CRS underwent assessment of GERD and sinus symptoms, esophageal motility testing, dual-channel esophageal pH testing, and laryngoscopy and nasal endoscopy at baseline. The results were compared to those of a group of GERDpatients without sinus problems. The CRSpatients alone then received omeprazole 20 mg b.i.d. for 3 months with symptom follow-up at monthly intervals. Laryngoscopy and nasal endoscopy were repeated at 3 months. RESULTS: Eleven patients with CRS and 19 GERDpatients participated. Eight CRSpatients experienced heartburn at least once weekly. Esophageal manometry and pH test results were similar between the two groups. Nine CRSpatients had an abnormal pH test. All 11 CRSpatients completed the 3-month course of omeprazole. Individual sinus symptoms (nasal congestion, nasal drainage, sinus pressure, facial headache, malaise) and global satisfaction were modestly improved in 25-89% and 91%, respectively, at 12 wk. Resolution of symptoms occurred infrequently. We identified no baseline variable that could predict symptom improvement. Although laryngoscopy and nasal endoscopy were abnormal in most CRSpatients at baseline and improved in some after treatment, these changes did not parallel symptom improvement. CONCLUSION: In this small, prospective, open label study, we demonstrated a high prevalence of GERD in patients with CRS, many of whom experienced modest sinus symptom improvement after using omeprazole b.i.d. for 3 months. These findings warrant further randomized, controlled study in a larger patient population.
Authors: David A Kleiman; Matthew J Sporn; Toni Beninato; Yasmin Metz; Carl Crawford; Thomas J Fahey; Rasa Zarnegar Journal: Surg Endosc Date: 2012-12-12 Impact factor: 4.584
Authors: Eli O Meltzer; Daniel L Hamilos; James A Hadley; Donald C Lanza; Bradley F Marple; Richard A Nicklas; Claus Bachert; James Baraniuk; Fuad M Baroody; Michael S Benninger; Itzhak Brook; Badrul A Chowdhury; Howard M Druce; Stephen Durham; Berrylin Ferguson; Jack M Gwaltney; Michael Kaliner; David W Kennedy; Valerie Lund; Robert Naclerio; Ruby Pawankar; Jay F Piccirillo; Patricia Rohane; Ronald Simon; Raymond G Slavin; Alkis Togias; Ellen R Wald; S James Zinreich Journal: Otolaryngol Head Neck Surg Date: 2004-12 Impact factor: 3.497
Authors: Eli O Meltzer; Daniel L Hamilos; James A Hadley; Donald C Lanza; Bradley F Marple; Richard A Nicklas; Claus Bachert; James Baraniuk; Fuad M Baroody; Michael S Benninger; Itzhak Brook; Badrul A Chowdhury; Howard M Druce; Stephen Durham; Berrylin Ferguson; Jack M Gwaltney; Michael Kaliner; David W Kennedy; Valerie Lund; Robert Naclerio; Ruby Pawankar; Jay F Piccirillo; Patricia Rohane; Ronald Simon; Raymond G Slavin; Alkis Togias; Ellen R Wald; S James Zinreich Journal: J Allergy Clin Immunol Date: 2004-12 Impact factor: 10.793