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Background <p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory condition affecting nasal passages and sinus cavities, often leading to symptoms such as nasal congestion, decreased sense of smell, nasal discharge, and facial pain. When medical management fails, functional endoscopic sinus surgery (FESS) is employed. However, surgical visibility and blood loss during the procedure can significantly impact outcomes.</p> Patients and methods <p>A double-blind, controlled randomized trial was conducted on 50 patients suffering from CRSwNP, who were randomly divided into two groups. Group A received 30&#xa0;mg of prednisolone orally 5&#xa0;days before surgery, while group B received the same dosage 10&#xa0;days before surgery. Surgical visibility was assessed using the Boezaart visibility score, and total operative blood loss and operative time were recorded.</p> Results <p>Group A exhibited a slightly higher surgical visibility score (1.93 ± 0.35) compared to group B (1.85 ± 0.23), although this difference was not statistically significant (<i>P</i> = 0.38). Conversely, group A had significantly higher total operative blood loss (172 ± 43.49&#xa0;ml) compared to group B (145 ± 30&#xa0;ml), with a significant <i>P</i>-value of 0.02. Operative times were nearly identical, averaging 146 ± 38.25&#xa0;min for group A and 145.8 ± 37.59&#xa0;min for group B, showing no significant difference (<i>P</i> = 0.99).</p> Conclusion <p>There was no significant difference in surgical field visibility or operative time in patients receiving preoperative 30&#xa0;mg/day of oral prednisone for 5&#xa0;days compared to 10&#xa0;days prior to endoscopic sinus surgery for sinonasal polyps. There was a statistically significant improvement in total operative blood loss; yet, the authors do not consider it clinically significant. Therefore, the authors would recommend the shorter 5-day course rather than the longer 10-day course.</p>

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The effect of different systemic corticosteroid durations on quality of surgical field in endoscopic sinus surgery for chronic rhinosinusitis with polyps

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月7日

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  • Mohamed Abd Elmottaleb Sabaa,
  • Meena Sameh Nasr,
  • Mahmoud Sayed ElFouly,
  • Refaat Nashed Behman

摘要

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory condition affecting nasal passages and sinus cavities, often leading to symptoms such as nasal congestion, decreased sense of smell, nasal discharge, and facial pain. When medical management fails, functional endoscopic sinus surgery (FESS) is employed. However, surgical visibility and blood loss during the procedure can significantly impact outcomes.

Patients and methods

A double-blind, controlled randomized trial was conducted on 50 patients suffering from CRSwNP, who were randomly divided into two groups. Group A received 30 mg of prednisolone orally 5 days before surgery, while group B received the same dosage 10 days before surgery. Surgical visibility was assessed using the Boezaart visibility score, and total operative blood loss and operative time were recorded.

Results

Group A exhibited a slightly higher surgical visibility score (1.93 ± 0.35) compared to group B (1.85 ± 0.23), although this difference was not statistically significant (P = 0.38). Conversely, group A had significantly higher total operative blood loss (172 ± 43.49 ml) compared to group B (145 ± 30 ml), with a significant P-value of 0.02. Operative times were nearly identical, averaging 146 ± 38.25 min for group A and 145.8 ± 37.59 min for group B, showing no significant difference (P = 0.99).

Conclusion

There was no significant difference in surgical field visibility or operative time in patients receiving preoperative 30 mg/day of oral prednisone for 5 days compared to 10 days prior to endoscopic sinus surgery for sinonasal polyps. There was a statistically significant improvement in total operative blood loss; yet, the authors do not consider it clinically significant. Therefore, the authors would recommend the shorter 5-day course rather than the longer 10-day course.