It is very well known through many RCTs and now meta-analyses that saline-based irrigation is beneficial in patients after sinus surgery. It is also demonstrated that intranasal steroids are beneficial postoperatively but there is also a trend for steroid based irrigation, in particular with budesonide and this paper attempts to address whether this is more beneficial than saline alone. Fifty patients in North Carolina who had failed medial treatment for chronic rhinosinusitis with nasal polyposis were randomised to normal saline irrigation and normal saline with budeosnide irrigation post endoscopic sinus surgery. The patients of four different surgeons were recruited. Patients were assessed using various validated quality of life questionnaires on three occasions, 1-2 weeks, 3-8 weeks and 3-6 months post operatively. The study follows the CONSORT guidelines and appropriate statistical analysis was used. Results concluded that both irrigation types improved quality of life scores at all points on the pathway but crucially there was no significant difference between the two. Larger scale studies would be beneficial but currently there appears to be no benefit in adding a steroid to a nasal irrigation fluid postoperatively.
Budesonide irrigation in polyposis
Reviewed by Suki Ahluwalia
Post-operative budesonide irrigations for patients with polyposis: a blinded, randomized controlled trial.
CONTRIBUTOR
Suki Ahluwalia
Cairns Hospital / James Cook University, Queensland, Australia.
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