Hashemian Farnaz, Sadegh Sonya, Jahanshahi Javaneh, Seif Rabiei Mohammad Ali, Hashemian Farshad
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Health Sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Iran J Otorhinolaryngol. 2020 Jan;32(108):21-28. doi: 10.22038/ijorl.2019.37766.2241.
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a relatively common disease with serious impacts on patient quality of life. Recurrence of polyps after functional endoscopic sinus surgery (FESS) is a dilemma. Vitamin D3 (VD3) is known to inhibit the proliferation of nasal polyp-derived fibroblasts. The present study aimed to investigate the effects of oral VD3 on the recurrence of polyposis after FESS.
This triple-blind placebo-controlled clinical trial was conducted on 40 patients with CRSwNP who did not respond to medical treatment and were candidates for FESS. In addition, the patients had VD3 insufficiency. Following the surgery, all the patients received routine treatment (i.e., fluticasone spray, irrigation, cefixime 400 mg daily for 10 days, and montelukast for a month). Moreover, the case group received oral VD3 tablets 4000 IU (single daily dose) for a month, and the control group received placebo in the same manner. The Sino-Nasal Outcome Test (SNOT-22) and Meltzer endoscopic grading scores were recorded at months 1, 3, and 6 after the study.
In this study, 6 months following the intervention, the severity of polyposis was reported to be significantly lower in the VD3 group compared to the placebo group based on SNOT-22 (16.25±10.16 in the VD3 group vs. 47.45±13.55 in the placebo group; P<0.001) and Meltzer scores (0.50±0.60 in the VD3 group vs. 2.65±0.93 in the placebo group; P<0.001). No adverse effects were observed in the case group.
This study showed the efficacy and safety of vitamin D supplementation in the reduction of polyposis recurrence after FESS in patients with CRSwNP.
伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）是一种相对常见的疾病，对患者生活质量有严重影响。功能性鼻内镜鼻窦手术（FESS）后息肉复发是一个难题。已知维生素D3（VD3）可抑制鼻息肉来源的成纤维细胞增殖。本研究旨在探讨口服VD3对FESS后息肉复发的影响。
本三盲安慰剂对照临床试验对40例对药物治疗无反应且适合FESS的CRSwNP患者进行。此外，这些患者存在VD3不足。手术后，所有患者均接受常规治疗（即氟替卡松喷雾、冲洗、头孢克肟400mg每日服用10天以及孟鲁司特服用1个月）。此外，病例组接受口服VD3片4000IU（每日单次剂量），持续1个月，对照组以相同方式接受安慰剂。在研究后的第1、3和6个月记录鼻窦结局测试（SNOT-22）和梅尔策内镜评分。
在本研究中，干预6个月后，基于SNOT-22（VD3组为16.25±10.16，安慰剂组为47.45±13.55；P<0.001）和梅尔策评分（VD3组为0.50±0.60，安慰剂组为2.65±0.93；P<0.001），VD3组息肉病的严重程度显著低于安慰剂组。病例组未观察到不良反应。
本研究表明补充维生素D在降低CRSwNP患者FESS后息肉复发方面的有效性和安全性。
