Role of Triamcinolone Irrigation in Postoperative Outcomes in Patients Operated for Chronic Rhinosinusitis: A Matched-Pair Randomized Controlled Trial.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2025-07-01 Epub Date: 2022-08-27 DOI:10.1177/01455613221123851
Grace Budhiraja, Navjot Kaur, Harsimrat Singh
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引用次数: 0

Abstract

Purpose: Endoscopic sinus surgery (ESS) is the standard treatment strategy for chronic rhinosinusitis (CRS) resistant to medical treatment, and it is known to have postoperative complications and recurrences, which in turn result in suboptimal outcomes. Several methods are used to prevent postoperative scarring, adhesions, oedema, infection or recurrences in cavities. The role of steroids in improving postoperative outcomes is well established. They can be administered systemically or locally to enhance drug delivery into paranasal sinuses. In this study, we used triamcinolone irrigation immediately following surgery on one side of the nose, in patients with bilateral disease. The objective of this study was to evaluate the effect of intra-operative triamcinolone irrigation on postoperative outcomes, in patients with bilateral pansinusitis.

Methods: It was an interventional randomized controlled study, conducted at a tertiary care centre in North India. The analysis of 58 patients with bilateral pansinusitis was done from September 2020 to August 2021. At the conclusion of ESS, each patient was randomized to receive triamcinolone irrigation (4 ml of 40mg/ml solution) once and followed by merocel (polyvinyl acetal) packing on one side, while the contralateral side was packed with merocel soaked with saline. Nasal cavities were evaluated using a Hopkins rod endoscope in the postoperative 1st, 3rd, 8th and 12th weeks to look for the presence of postoperative crusting, oedema, polypoidal changes, and discharge. Perioperative sinus endoscopic scores (POSE) were used for endoscopic staging.

Results: The most commonly affected age group was 31-45 years accounting for 39.7%. Males were affected more (63.7%) than the female population (36.3%). There was a reduction in the average POSE scores at the treatment site at all follow-up stages with a significant reduction in crusting, oedema, and scarring in the treatment site (P-value <0.001).

Conclusion: Triamcinolone irrigation effectively improves postoperative outcomes and reduces early postoperative complications in CRS patients.

三苯氧胺冲洗对慢性鼻炎患者术后效果的影响:配对随机对照试验。
目的:内窥镜鼻窦手术(ESS)是治疗对药物治疗无效的慢性鼻窦炎(CRS)的标准治疗策略,但已知术后会出现并发症和复发,进而导致疗效不理想。有几种方法可用于预防术后瘢痕、粘连、水肿、感染或腔隙复发。类固醇在改善术后效果方面的作用已得到公认。类固醇可以全身或局部给药,以加强药物在副鼻窦内的输送。在这项研究中,我们对双侧鼻腔疾病患者在一侧鼻腔手术后立即使用曲安奈德灌洗。本研究的目的是评估术中三苯氧胺灌洗对双侧鼻窦炎患者术后效果的影响:这是一项介入性随机对照研究,在印度北部的一家三级医疗中心进行。从 2020 年 9 月到 2021 年 8 月,对 58 名双侧脓窦炎患者进行了分析。ESS结束后,每位患者随机接受一次曲安奈德灌洗(4毫升40毫克/毫升溶液),然后一侧接受美罗凯尔(聚乙烯醇缩醛)填塞,对侧则用生理盐水浸泡的美罗凯尔填塞。在术后第 1、3、8 和 12 周,使用霍普金斯杆状内窥镜对鼻腔进行评估,以观察是否存在术后结痂、水肿、息肉样变和分泌物。围手术期鼻窦内窥镜评分(POSE)用于内窥镜分期:最常患病的年龄组为 31-45 岁,占 39.7%。男性患者(63.7%)多于女性患者(36.3%)。在所有随访阶段,治疗部位的平均 POSE 评分均有所下降,治疗部位的结痂、水肿和瘢痕明显减少(P 值 结论:三唑酮冲洗能有效改善膀胱癌的治疗效果:曲安奈德灌洗能有效改善 CRS 患者的术后效果,减少术后早期并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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