Treatment of recurrent chronic hyperplastic sinusitis with nasal polyposis.
OBJECTIVE
To demonstrate the long-term efficacy of intranasal furosemide, an inhibitor of the sodium chloride cotransporter channel at the basolateral surface of the respiratory epithelial cell, vs no therapeutic intervention vs intranasal mometasone furoate, a corticosteroid, in preventing relapses of chronic hyperplastic sinusitis with nasal polyposis.


METHODS
Randomized prospective controlled study. Patients were examined every 6 months during follow-up (range, 1-9 years).


METHODS
One hundred seventy patients with bilateral obstructive or minimally obstructive chronic hyperplastic sinusitis with nasal polyposis.


METHODS
All patients were surgically treated in the ENT Department, University of Siena Medical School. One month after surgery, group 1 patients (n = 97) started treatment with intranasal furosemide, group 2 (n = 40) received no therapeutic treatment, and group 3 (n = 33) were treated with mometasone.


METHODS
Clinical and instrumental evaluation of postoperative outcomes.


RESULTS
Seventeen (17.5%) of 97 patients in group 1, 12 (30.0%) of 40 patients in group 2, and 8 (24.2%) of 33 patients in group 3 experienced nasal polyposis relapses. We noted a prevalence of early-stage relapse in patients treated with furosemide or mometasone, whereas patients who did not receive any treatment experienced more severe grades of chronic hyperplastic sinusitis with nasal polyposis (P<.005).


CONCLUSIONS
Use of intranasal furosemide represents a valid therapeutic treatment in the prevention of chronic hyperplastic sinusitis with nasal polyposis.
Passàli
Desiderio
D
ENT Department, University of Siena Medical School, Siena, Italy. Passali@unisi.it
Bernstein
Joel M
JM
Passali
Francesco Maria
FM
Damiani
Valerio
V
Passàli
Giulio Cesare
GC
Bellussi
Luisa
L
D000281:Administration, Intranasal; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005665:Furosemide / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D015508:Nasal Obstruction / Q000150:complications / Q000188:drug therapy*; D009298:Nasal Polyps / Q000150:complications / Q000188:drug therapy*; D010256:Paranasal Sinuses / Q000473:pathology*; D011244:Pregnadienediols / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D055502:Secondary Prevention; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D049992:Sodium Chloride Symporters; D027981:Symporters / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D004232:Diuretics; D011244:Pregnadienediols; D049992:Sodium Chloride Symporters; D027981:Symporters; D000068656:Mometasone Furoate; D005665:Furosemide