Muzaffer Kırıs1, Togay Muderris2, Gökhan Yalçıner2, Sami Bercin1, Ergun Sevil3, Fatih Gul4. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Yıldırım Beyazıt University, Ankara, Turkey. 2. Department of Otorhinolaryngology-Head and Neck Surgery, Ataturk Education and Research Hospital, Ankara, Turkey. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Karaman State Hospital, Karaman, Turkey. 4. Department of Otorhinolaryngology-Head and Neck Surgery, Bitlis Tatvan State Hospital, Bitlis, Turkey.
Abstract
OBJECTIVES/HYPOTHESIS: Local and systemic steroid treatment is the mainstay of therapy for nasal polyposis. This study aims to evaluate the safety and effectiveness of intrapolyp steroid injection on nasal polyposis and to compare the outcomes with short-term oral steroid treatment. STUDY DESIGN: Prospective, randomized, controlled endoscopic clinical trial. METHODS:Ninety patients with nasal polyps were randomly assigned in a 1:1 ratio to receive oral prednisolone 1 mg/kg/day, tapering by 5 mg/day, for 2 weeks, or to receive intrapolyp steroid injection (40 mg/mL triamcinolone, 1 mL) for up to five times with intervals of 1 week. Both groups received fluticasone propionate nasal drops twice daily for 12 weeks after initial treatment. Total nasal symptoms scores and total nasal polyp scores of both groups were evaluated before and 3 and 6 months after treatment, whereas computed tomography (CT) scores were evaluated before and 6 months after treatment. Also, plasma cortisol and adrenocorticotropic hormone (ACTH) levels of the patients in the intrapolyp steroid injection group were evaluated before, during, and after treatment. RESULTS: A total of 211 injections were given to 45 patients, and no serious complications were observed. Both groups showed significant decrease in symptom score, polyp score, and CT score (P > 0.001), with no significant difference between groups (P > 0.05). Plasma cortisol and ACTH levels of the injected patients were in normal limits before treatment, 1 week after the first injection, and 1 week after the last injection. CONCLUSION: Intrapolyp steroid injection appears to be an effective and safe method for treatment of nasal polyps, with comparable results to oral short-term steroid treatment. LEVEL OF EVIDENCE: 1b. Laryngoscope, 126:1730-1735, 2016.
RCT Entities:
OBJECTIVES/HYPOTHESIS: Local and systemic steroid treatment is the mainstay of therapy for nasal polyposis. This study aims to evaluate the safety and effectiveness of intrapolyp steroid injection on nasal polyposis and to compare the outcomes with short-term oral steroid treatment. STUDY DESIGN: Prospective, randomized, controlled endoscopic clinical trial. METHODS: Ninety patients with nasal polyps were randomly assigned in a 1:1 ratio to receive oral prednisolone 1 mg/kg/day, tapering by 5 mg/day, for 2 weeks, or to receive intrapolyp steroid injection (40 mg/mL triamcinolone, 1 mL) for up to five times with intervals of 1 week. Both groups received fluticasone propionate nasal drops twice daily for 12 weeks after initial treatment. Total nasal symptoms scores and total nasal polyp scores of both groups were evaluated before and 3 and 6 months after treatment, whereas computed tomography (CT) scores were evaluated before and 6 months after treatment. Also, plasma cortisol and adrenocorticotropic hormone (ACTH) levels of the patients in the intrapolyp steroid injection group were evaluated before, during, and after treatment. RESULTS: A total of 211 injections were given to 45 patients, and no serious complications were observed. Both groups showed significant decrease in symptom score, polyp score, and CT score (P > 0.001), with no significant difference between groups (P > 0.05). Plasma cortisol and ACTH levels of the injected patients were in normal limits before treatment, 1 week after the first injection, and 1 week after the last injection. CONCLUSION: Intrapolyp steroid injection appears to be an effective and safe method for treatment of nasal polyps, with comparable results to oral short-term steroid treatment. LEVEL OF EVIDENCE: 1b. Laryngoscope, 126:1730-1735, 2016.
Authors: María Isabel Delgado-Dolset; David Obeso; Javier Sánchez-Solares; Leticia Mera-Berriatua; Paloma Fernández; Coral Barbas; Miguel Fresnillo; Tomás Chivato; Domingo Barber; María M Escribese; Alma Villaseñor Journal: Front Mol Biosci Date: 2021-05-14