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Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis.
Allergy. 2009 May; 64(5):762-9.A

Abstract

BACKGROUND

Nasal polyposis is a disease known to be associated with asthma. The management is anti-inflammatory, with topical and oral corticosteroids as the first-line treatment. The effect of surgical treatment on lower airway inflammation has not been sufficiently studied.

AIM

The aim of this study is to investigate the effects of functional endoscopic sinus surgery (FESS) as well as fluticasone proprionate nasal drops (FPND) 400 microg b.i.d. on nasal and lower airway parameters in asthmatics with nasal polyposis.

METHODS

This was a prospective 21-week study of 68 patients with asthma and nasal polyposis, on the benefits of FESS on nasal '(butanol test, subjective olfaction, peak nasal inspiratory flow, congestion, rhinorrhoea, and polyp score)', and on the lower airway parameters (dyspnea, cough, mean daily peak expiratory flow rate (PEFR), and lung function tests). It also included a randomized, double-blind, placebo-controlled 14 weeks phase on FPND.

RESULTS

Functional endoscopic sinus surgery significantly improved mean asthma symptom scores and daily PEFR and all nasal parameters including subjective and objective olfaction tests. This is the first study that shows the benefits of FESS on butanol tests in patients with nasal polyposis. We found no significant difference between topical treatment with FPND or placebo in the nasal or lower airway variables.

CONCLUSION

Functional endoscopic sinus surgery improved nasal and asthma symptoms in patients with nasal polyposis. Functional endoscopic sinus surgery could be considered early in the natural course of nasal polyposis with concomitant asthma, as well as a second-line treatment in nasal polyposis patients with a reduced sense of smell. The potential benefits of FPND 400 microg b.i.d. were probably overshadowed by FESS.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Ehnhage A
Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institutet, Stockholm.
Olsson P
No affiliation info available
Kölbeck KG
No affiliation info available
Skedinger M
No affiliation info available
Dahlén B
No affiliation info available
Alenius M
No affiliation info available
Stjärne P
No affiliation info available
NAFS Study Group
No affiliation info available

MeSH

AdultAgedAndrostadienesAnti-Allergic AgentsAsthmaDouble-Blind MethodEndoscopyFemaleFluticasoneHumansMaleMiddle AgedNasal PolypsOlfaction DisordersParanasal SinusesPeak Expiratory Flow RateProspective StudiesSmell

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19191775

Citation

Ehnhage, A, et al. "Functional Endoscopic Sinus Surgery Improved Asthma Symptoms as Well as PEFR and Olfaction in Patients With Nasal Polyposis." Allergy, vol. 64, no. 5, 2009, pp. 762-9.
Ehnhage A, Olsson P, Kölbeck KG, et al. Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis. Allergy. 2009;64(5):762-9.
Ehnhage, A., Olsson, P., Kölbeck, K. G., Skedinger, M., Dahlén, B., Alenius, M., & Stjärne, P. (2009). Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis. Allergy, 64(5), 762-9. https://doi.org/10.1111/j.1398-9995.2008.01870.x
Ehnhage A, et al. Functional Endoscopic Sinus Surgery Improved Asthma Symptoms as Well as PEFR and Olfaction in Patients With Nasal Polyposis. Allergy. 2009;64(5):762-9. PubMed PMID: 19191775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis. AU - Ehnhage,A, AU - Olsson,P, AU - Kölbeck,K-G, AU - Skedinger,M, AU - Dahlén,B, AU - Alenius,M, AU - Stjärne,P, AU - ,, Y1 - 2009/02/02/ PY - 2009/2/5/entrez PY - 2009/2/5/pubmed PY - 2009/6/10/medline SP - 762 EP - 9 JF - Allergy JO - Allergy VL - 64 IS - 5 N2 - BACKGROUND: Nasal polyposis is a disease known to be associated with asthma. The management is anti-inflammatory, with topical and oral corticosteroids as the first-line treatment. The effect of surgical treatment on lower airway inflammation has not been sufficiently studied. AIM: The aim of this study is to investigate the effects of functional endoscopic sinus surgery (FESS) as well as fluticasone proprionate nasal drops (FPND) 400 microg b.i.d. on nasal and lower airway parameters in asthmatics with nasal polyposis. METHODS: This was a prospective 21-week study of 68 patients with asthma and nasal polyposis, on the benefits of FESS on nasal '(butanol test, subjective olfaction, peak nasal inspiratory flow, congestion, rhinorrhoea, and polyp score)', and on the lower airway parameters (dyspnea, cough, mean daily peak expiratory flow rate (PEFR), and lung function tests). It also included a randomized, double-blind, placebo-controlled 14 weeks phase on FPND. RESULTS: Functional endoscopic sinus surgery significantly improved mean asthma symptom scores and daily PEFR and all nasal parameters including subjective and objective olfaction tests. This is the first study that shows the benefits of FESS on butanol tests in patients with nasal polyposis. We found no significant difference between topical treatment with FPND or placebo in the nasal or lower airway variables. CONCLUSION: Functional endoscopic sinus surgery improved nasal and asthma symptoms in patients with nasal polyposis. Functional endoscopic sinus surgery could be considered early in the natural course of nasal polyposis with concomitant asthma, as well as a second-line treatment in nasal polyposis patients with a reduced sense of smell. The potential benefits of FPND 400 microg b.i.d. were probably overshadowed by FESS. SN - 1398-9995 UR - https://www.unboundmedicine.com/medline/citation/19191775/Functional_endoscopic_sinus_surgery_improved_asthma_symptoms_as_well_as_PEFR_and_olfaction_in_patients_with_nasal_polyposis_ DB - PRIME DP - Unbound Medicine ER -