A study on role of adjuvant steroid therapy in patients with sinonasal polyposis.

Vinod Jose, Kakkanatt (2009) A study on role of adjuvant steroid therapy in patients with sinonasal polyposis. Masters thesis, Madras Medical College, Chennai.


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Chronic rhinosinusitis with sinonasal polyposis is a common problem that exacts a high cost in terms of direct health care as well as lost productivity.The common pathophysiologic denominator for virtually all forms of Chronic RhinoSinusitis (CRS) is inflammation, for which extensive pharmacotherapy is available including topical corticosteroids, antibiotics, saline irrigations and systemic steroids. Unfortunately, not all patients are cured or achieve control of their symptoms even with maximal pharmacotherapy. In these patients who have failed medical management, endoscopic sinus surgery(ESS) has been demonstrated and is generally accepted to provide improved relief of symptoms and better quality of life. ESS is a commonly performed procedure, with an estimated 1000 procedures performed annually in our institute-Upgraded Institute of Otorhinolaryngology in Madras Medical College in Chennai. Although there is some controversy as to the best or most appropriate surgical technique for treating patients with Chronic Rhinosinusitis with Sinonasal polyposis (CRSwP) most surgeons will recommend that these patients undergo polypectomy6, complete ethmoidectomy, and middle meatal antrostomy, with or without frontal sinusotomy or sphenoidotomy. However, there is significant variability and a lack of standardization or guidelines4 with respect to the preparation and peri-operative pharmacotherapy regimen and management for patients undergoing ESS for CRSwP. The treatment of Chronic Rhinosinusitis with Sinonasal Polyposis is Endoscopic Polypectomy. This has been well proven over many years. But the role of corticosteroids an its administration is debatable over many years. In this study this debate has taken into the topic of study. Controlled studies have shown that topical steroids can delay the recurrence of polyps after surgery. However the effect is partial especially in cases of pronounced inflammatory activity. Based on the data collected and analyzed in this study, several conclusions can be drawn as related to the study objectives. Lastly, the peri-operative administration of adjuvant steroids are also beneficial to prevent the post-operative complications like post-op scarring, synechiae formation, post-op crusting and to prevent recurrence.

Item Type: Thesis (Masters)
Uncontrolled Keywords: adjuvant steroid therapy; sinonasal polyposis
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 04 Jul 2017 07:38
Last Modified: 04 Jul 2017 07:38
URI: http://repository-tnmgrmu.ac.in/id/eprint/888

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