Efficacy of nasal irrigation of normal saline as compared to budesonide following functional endoscopic sinus surgery

Areena Anjum; Farkhanda Majeed; Shahid A. Mir; Parmod Kalsotra; Zuha Showket

doi:10.18203/2320-6012.ijrms20231338

Authors

Areena Anjum Department of ENT, Government Medical College, Jammu, India
Farkhanda Majeed Department of ENT, Government Medical College, Jammu, India
Shahid A. Mir Department of Neuroanaesthesiology and Critical Care, AIIMS, New Delhi, India
Parmod Kalsotra Department of ENT, Government Medical College, Jammu, India
Zuha Showket Department of Paediatrics, Khwaja Yunus Ali Medical College and Hospital, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231338

Keywords:

Budesonide, LKES, Normal saline, Nasal irrigation

Abstract

Background: Nasal irrigation following Functional endoscopic sinus surgery (FESS) appears to be a nearly universal recommendation. FESS significantly improves the symptoms of the CRS (Chronic rhino sinusitis) and the postoperative endoscopy scores. The primarily objective of our study was to study the efficacy of nasal irrigation of normal saline as compared to budesonide following functional endoscopic sinus surgery.

Methods: A total of 100 patients who underwent functional endoscopic sinus surgery were randomly divided into two groups on the basis of computerized generated random table with 50 patients in each group. In group 1 normal saline was used where as in group 2 budesonide solution was used for nasal douching. Post-operative evaluation was done using Lund Kennedy Endoscopic scoring (LKES) at the 7th and 30th postoperative day.

Results: On 7th postoperative day, we found that none of our patient in the study groups had polypoidal change. There was decrease in scores of polyposis, discharge mucosal edema, scaring and crusting in both the groups. However, the reduction of discharge in the budesonide group was more significantly decreased than normal saline group (p value<0.05). We also noted that on 30th postoperative edema, scarring and crusting was significantly decreased in budesonide group as compared to normal saline group (p value <0.05).

Conclusions: We concluded that the addition of budesonide in nasal irrigation resulted in improved scores of polyposis, discharge, mucosal edema, crusting and scarring and total score of LKES than normal saline alone.

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References

Heatley DG, McConnell KE, Kille TL, Leverson GE. Nasal irrigation for the alleviation of sinu nasal symptoms. Otolaryngol Head Neck Surg. 2001;125:44-8.

Rabago D, Zgierska A, Bamber A, Peppard P. The use of nasal saline irrigation among Family Medicine physicians in Wisconsin. Wisconsin Med J. 2009;5:83-9.

Shi JB, Fu QL, Zhang H, Cheng L, Wang YJ, Zhu DD et al. Epidemiology of chronic rhino sinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy. 2015;70:533-9.

Hastan D, Fokkens W, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, et al. Chronic rhino sinusitis in Europe an underestimated disease. A GA2LEN study. Allergy. 2011;66:1216-23.

Chen XZ, Feng SY, Chang LH, Xiaoping LC, Xiaohong L Xia, et al. The effects of nasal irrigation with different solutions after endoscopic sinus surgery: a systematic review and metaanalysis. J Laryngol Otol. 2018;6:1-7.

Fandin M, Macdonald KI, Lee J, Witterick IJ. The use of postoperative topical corticosteroids in chronic rhino sinusitis with nasal polyps: A systematic review and meta-analysis. Am J Rhinol Allergy. 2013;27:e146-57.

Garg D, Kamble A, Putterwar M. Demographic and clinical profile of chronic rhino sinusitis patients in a rural based tertiary hospital. Int J Otorhinolarynlogol Head Neck Surg. 2019;5(5):1-5.

Chaturvedi A, Grewal DS.A cross sectional study on demographic and clinical profile of chronic rhino sinusitis (CRS) patients in a tertiary care hospital. Gal Int J Health Sci Res. 2020;5(1):17-9.

Tripathy SM, Panda R. Comparative study of hypertonic saline nasal douching in postoperative endoscopic sinus surgery patients. Int J Otorhinololaryngology Head Neck Surg. 2019;5(3):598-602.

Salib RJ, Talpallikar S, Uppal S, Nair SB.A prospective randomized single blinded clinical trial comprising the efficacy and tolerability of nasal douching products Sterimer TM and Sinus Rinse TM following endoscopic sinus surgery. Clin Otolaryngol. 2013;38(4):297-305.

Kumar J, Padiyar Bv, Malik P, Kumar A. The effect of hypertonic saline versus isotonic saline irrigation following endoscopic sinus surgery. a comperative study. Glob J Oto. 2018;15(5):1-5.

Deal RT, Kountakis SE. Significance of nasal polyps in chronic rhinosinusitis: symptoms and surgical outcomes. Laryngoscope. 2004;114(11):1932-5.

Yoo F, Ference EH, Kuan EC, Lee JT, Wang MB, Suh JD. Evaluation Of Patient Nasal Saline Irrigation Practices Following Endoscopic Sinus Surgery. Int Forum Allergy Rhinol. 2018;8(1):32-40.