A more comprehensive management for eosinophilic chronic rhinosinusitis after FESS
Reviewed by Madhup K Chaurasia

In recent years there has been increasing recognition of eosinophilic chronic rhinosinusitis which, in particular, results in persistent symptoms and recurrence of nasal polyps, even after FESS surgery. It therefore calls for measures adjuvant to FESS to stop persistence of this condition which affects quality of life. This study comprises two groups of patients with chronic eosinophilic rhinosinusitis; one group which received intranasal triamcinolone acetamide placed within the ethmoid sinuses and in the olfactory cleft with oxidised regenerated cellulose, and the other group which did not receive this postoperative treatment. A total nasal symptom score was used for comparison along with postoperative endoscopic appearance of ethmoid sinuses. The degree of severity of chronic sinusitis was evaluated by Lund and Mackay CT scoring system. This was also supported by olfactory evaluation by use of an olfactometer. No patients had systemic absorption leading to hyperadrenocorticism. The results, in terms of control of nasal symptoms, were significantly better with use of intranasal steroid treatment after FESS surgery in patients with eosinophilic chronic rhinosinusitis. The authors emphasise the need for this, especially in younger patients with polyposis. Intranasal steroids are often used postoperatively but this article illustrates the benefits of more precise topical application of steroids.

Therapeutic indications for sinunasal topical steroid treatment and its effects of eosinophilic chronic rhinusinusitis after endoscopic sinus surgery.
Saito T, Okazaki K, Hamada Y, et al.
J LARYNGOL OTOL
2021;135(10):858-63.