title: Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis.
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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institutet, Stockholm.
authors.forename: A
authors.initials: A
authors.lastname: Ehnhage
authors.forename: P
authors.initials: P
authors.lastname: Olsson
authors.forename: K-G
authors.initials: KG
authors.lastname: Kölbeck
authors.forename: M
authors.initials: M
authors.lastname: Skedinger
authors.forename: B
authors.initials: B
authors.lastname: Dahlén
authors.forename: M
authors.initials: M
authors.lastname: Alenius
authors.forename: P
authors.initials: P
authors.lastname: Stjärne
mesh_terms: D000328:Adult; D000368:Aged; D000730:Androstadienes / Q000008:administration & dosage*; D018926:Anti-Allergic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D004311:Double-Blind Method; D004724:Endoscopy; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D000857:Olfaction Disorders / Q000150:complications / Q000601:surgery; D010256:Paranasal Sinuses / Q000601:surgery*; D010366:Peak Expiratory Flow Rate; D011446:Prospective Studies; D012903:Smell / Q000276:immunology
chemical_list: D000730:Androstadienes; D018926:Anti-Allergic Agents; D000068298:Fluticasone