A systematic review of the use of intranasal steroids in the treatment of chronic rhinosinusitis
- 30 September 2008
- journal article
- review article
- Published by Wiley in Otolaryngology -- Head and Neck Surgery
- Vol. 139 (3), 340-347
- https://doi.org/10.1016/j.otohns.2008.05.628
Abstract
OBJECTIVE: To determine if intranasal steroids (INS) are useful in the management of chronic rhinosinusitis without polyps and chronic rhinosinusitis (CRS) with polyps. DATA SOURCES: Studies for inclusion were searched using Medline, EMBASE, Cochrane databases, and references of included studies. REVIEW METHODS: Initial screening of article titles and abstracts obtained from the literature search was performed independently by two reviewers (SAJ and RT) based on the research protocol criteria. These articles then underwent a second-stage review. Each article was read in detail and discussed by the two reviewers before inclusion in the study. RESULTS: The review yielded 13 studies regarding the treatment of sinonasal polyps with intranasal steroids. Six of these could be included in the meta-analysis. The outcome measure used for meta-analysis was change in polyp size from baseline compared between the treatment and control groups. Results from both conservative and optimistic selection of treatment effect are positive, providing significant improvement in polyp size in the treatment group as compared to controls. In the conservative estimate, the mean improvement in polyp size score between the treatment and placebo group is 0.43 with a 95% CI of [0.25, 0.61]. Of those treatment groups with the largest improvement, the mean improvement in polyp size score can go as high as 0.63 with a 95% CI of [0.43, 0.82]. CONCLUSION: Intranasal steroids are beneficial in the treatment of chronic rhinosinusitis with sinonasal polyps. Further studies looking at the use of INS in the treatment of CRS without polyps are warranted.Keywords
This publication has 18 references indexed in Scilit:
- The efficacy and safety of once-daily mometasone furoate nasal spray in nasal polyposis: a randomized, double-blind, placebo-controlled studyActa Oto-Laryngologica, 2006
- Efficacy and safety of mometasone furoate nasal spray in nasal polyposisJournal of Allergy and Clinical Immunology, 2005
- Editors and Reviewers: Supporting Peer-Review PublishingOtolaryngology -- Head and Neck Surgery, 2003
- Efficacy and tolerability of fluticasone propionate nasal drops 400 μg once daily compared with placebo for the treatment of bilateral polyposis in adultsClinical & Experimental Allergy, 2000
- Dose‐related efficacy and tolerability of fluticasone propionate nasal drops 400 μg once daily and twice daily in the treatment of bilateral nasal polyposis: a placebo‐controlled randomized study in adult patientsClinical and Experimental Allergy, 2000
- Fluticasone Propionate Aqueous Nasal Spray in the Treatment of Nasal PolyposisAnnals of Allergy, Asthma & Immunology, 1997
- Efficacy of topical corticosteroid powder for nasal polyps: a double-blind, placebo-controlled study of budesonideClinical Otolaryngology, 1995
- The effect of budesonide (Rhinocort ) in the treatment of small and medium-sized nasal polypsClinical Otolaryngology, 1993
- Publication bias in clinical researchThe Lancet, 1991
- A double-blind comparison of intranasal budesonide with placebo for nasal polyposisJournal of Allergy and Clinical Immunology, 1990