Nehra Sukriti, Choudhury Bikram, Goyal Amit, Soni Kapil, Sharma Vidhu, Tiwari Sarbesh
Department of Otorhinolaryngology, PGI Satellite Centre, Sangrur, India.
Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, India.
J Rhinol. 2024 Nov;31(3):145-150. doi: 10.18787/jr.2024.00024. Epub 2024 Nov 30.
This study aimed to evaluate whether preoperative oral prednisolone improves the intraoperative parameters and postoperative outcomes over a 3-month period in patients of sinonasal polyposis who undergo functional endoscopic sinus surgery.
In a triple-blind, randomized controlled study, 43 patients diagnosed with sinonasal polyposis in the Department of ENT, AIIMS, Jodhpur, were enrolled. After obtaining institutional ethics clearance and registering the clinical trial, randomization was conducted to assign participants into experimental and control groups. Preoperatively, patients were assessed using the clinical severity score (Sino-nasal Outcome Test; SNOT-22), radiological severity score (Lund-Mackay score), and endoscopic severity scores (discharge-inflammation-polyp [DIP] score and Lund-Kennedy score). Intraoperative assessment was done using the Perioperative Sinus Endoscopy (POSE) score, the duration of surgery, intraoperative blood loss, and visual analog scale for visual field during surgery and for the ease of disease removal. Postoperatively, at 3 months all the preoperative parameters were reassessed, and, using independent t-test, comparison was made between the two groups.
Twenty-one patients were included in the experimental group (48%), and 22 in the control group (51%). Although the mean duration of surgery in the experimental group was shorter than in the control group, the difference was not statistically significant. Similarly, although the postoperative SNOT-22 score was lower in the experimental group compared to the control group, there was no statistically significant difference in outcomes between the two groups across any of the parameters assessed.
Although the role of oral steroids has been established in the treatment of sinonasal polyposis, our study did not find any significant difference between the group that received oral steroids prior to surgery and the group that received placebo.
本研究旨在评估术前口服泼尼松龙是否能改善接受功能性鼻内镜鼻窦手术的鼻息肉患者在3个月内的术中参数和术后结果。
在一项三盲随机对照研究中，纳入了焦特布尔全印医学科学研究所耳鼻喉科诊断为鼻息肉的43例患者。获得机构伦理批准并注册临床试验后，进行随机分组，将参与者分为实验组和对照组。术前，使用临床严重程度评分（鼻窦结局测试；SNOT-22）、放射学严重程度评分（Lund-Mackay评分）以及内镜严重程度评分（分泌物-炎症-息肉[DIP]评分和Lund-Kennedy评分）对患者进行评估。术中评估采用围手术期鼻窦内镜检查（POSE）评分、手术时长、术中失血量以及手术期间视野和疾病切除难易程度的视觉模拟量表。术后3个月时，重新评估所有术前参数，并使用独立t检验对两组进行比较。
实验组纳入21例患者（48%），对照组纳入22例患者（51%）。尽管实验组的平均手术时长比对照组短，但差异无统计学意义。同样，尽管实验组术后SNOT-22评分低于对照组，但在评估的任何参数方面，两组之间的结果均无统计学显著差异。
尽管口服类固醇在鼻息肉治疗中的作用已得到确立，但我们的研究未发现术前接受口服类固醇的组与接受安慰剂的组之间存在任何显著差异。
