Levytska Svitlana, Schomer Donald F, Baptista Peter, Schellingerhout Dawid, Haider Ali S, Ross Harry
Department of Otolaryngology, Chernivtsi Medical College, Chernivtsi, UKR.
Department of Neuroradiology, MD Anderson Cancer Center, Houston, USA.
Cureus. 2025 Aug 2;17(8):e89251. doi: 10.7759/cureus.89251. eCollection 2025 Aug.
This study evaluates a novel route of administration for the treatment of refractory chronic rhinosinusitis (CRS).
This prospective case series, conducted at a single institution, included 11 patients with refractory chronic rhinosinusitis (CRS) who had not responded to maximal medical therapy (MMT). Each patient received an antibiotic/steroid solution administered via sinus puncture and lavage (SP&L) into the anterior ethmoid air cells under topical anesthesia. SP&L procedures were performed on days one, three, and five of the study. Sino-Nasal Outcome Test-22 (SNOT-22) scores were recorded in the clinic before the first SP&L (day one), after the final lavage (day five), and at the final follow-up visit on day 30. Baseline SNOT-22 scores from day one were compared to those obtained on days five and 30 to assess symptom changes over time.
Ten patients completed the study, with nine patients receiving durable relief. The median baseline SNOT-22 score was 31, the median day five SNOT-22 score was 6.5, and the median day 30 SNOT-22 score was 9. Mean±SD was 30.4±3.1, 8.9±5.9, and 11.1±9.5, respectively. Compared to baseline, the SNOT-22 scores at both day five and day 30 were highly significantly decreased (p < 0.0001).
Intra-ethmoid lavage of antibiotic/steroid solution appears to be an effective, easily performed, and safe procedure for CRS patients refractory to MMT.
本研究评估一种用于治疗难治性慢性鼻-鼻窦炎（CRS）的新型给药途径。
本前瞻性病例系列研究在单一机构进行，纳入了11例对最大程度药物治疗（MMT）无反应的难治性慢性鼻-鼻窦炎（CRS）患者。每位患者在局部麻醉下通过鼻窦穿刺冲洗（SP&L）将抗生素/类固醇溶液注入前筛窦气房。在研究的第1天、第3天和第5天进行SP&L操作。在首次SP&L（第1天）前、末次冲洗后（第5天）以及第30天的最终随访时在门诊记录鼻-鼻窦结局测试-22（SNOT-22）评分。将第1天的基线SNOT-22评分与第5天和第30天获得的评分进行比较，以评估症状随时间的变化。
10例患者完成研究，9例患者获得持久缓解。基线SNOT-22评分中位数为31，第5天SNOT-22评分中位数为6.5，第30天SNOT-22评分中位数为9。均值±标准差分别为30.4±3.1、8.9±5.9和11.1±9.5。与基线相比，第5天和第30天的SNOT-22评分均显著降低（p < 0.0001）。
对于对MMT难治的CRS患者，筛窦内冲洗抗生素/类固醇溶液似乎是一种有效、易于实施且安全的方法。
