Efficacy of Budesonide Nasal Irrigation in Comparison to Normal Saline Irrigation in Post-Operative Management of Functional Endoscopic Sinus Surgery.

Abstract

Background Nasal irrigation with normal saline and topical steroid spray forms the mainstay of treatment in post endoscopic sinus surgery patients. However nasal sprays may not deliver optimum dosage of drug to the paranasal sinus mucosa. Budesonide nasal irrigation solves this problem by delivering drugs in a high-volume high-pressure system. Objective The main objectiveof this study will provide insight into the efficacy of budesonide nasal irrigation following functional endoscopic sinus surgery (FESS) surgery and will help to establish new protocols in future. Method Forty-four patients were included and divided into 2 groups of 22 each. One arm received normal saline nasal irrigation and the other arm received budesonide nasal irrigation (1 mg in 500 ml) twice daily. Patients were followed up at 1st post-operative week and 10th post-operative week and on each visit Sino-Nasal Outcome Test (SNOT) 22 and Lund Kennedy Endoscopic scores (LKES) were assessed. Result The mean scores in the first visit was SNOT 22 : 15.73 + 8.897 vs 12.73 + 16.110 (p < 0.05) and LKES : 2.82 + 1.097 vs 1.77 + 1.52 (p > 0.05) in the saline and budesonide groups respectively. The mean scores in the second visit was SNOT 22 : 7.09+3.87 vs 3.73 + 8.70 (p < 0.05) and LKES : 1.64 + 0.790 vs 0.18 + 0.501 (p < 0.05) in the saline and budesonide groups respectively. Thus the budesonide arm had statistically significantly better scores when compared to the normal saline group. Conclusion Budesonide nasal irrigation with a positive pressure high volume device was found to have better efficacy when compared to normal saline irrigation. Budesonide nasal irrigation may be used in the post-operative management of endoscopic sinus surgery patients.