[Preoperative corticosteroid treatment and nasal polyposis].
OBJECTIVE
Impairment of the surgical view by bleeding in endoscopic ethmoidectomy for chronic rhinosinusitis with nasal polyps (CRSwNP) contributes to the risk of skull base injuries. The aim of this study was to investigate the effect of a short course of a systemic corticoid treatment on bleeding and surgical field quality during endoscopic ethmoidectomy for CRSwNP.


METHODS
A prospective study was conducted on 40 patients. Before surgery, 21 of them (group B) were treated with 1 mg/kg per day of prednisolone for seven days. They were compared with the 19 other patients (group A) on intraoperative blood loss and surgery duration.


RESULTS
The two groups shared identical clinical features (Lidholdt endoscopic grading). There was no statistical difference in terms of bleeding, although the Lund-Mackay CT score was higher in group B (19/24 vs. 21/24, p=0.05). The surgical procedure was shorter in group B (72 min vs. 85 min, p=0.05).


CONCLUSIONS
Preoperative treatment with systemic corticosteroids does not seem to reduce surgical blood loss. However, we noted a decrease in the procedure's duration. By reducing mucous inflammation, this treatment could improve the local conditions and help the surgeon in the mucous eradication.
Giordano
J
J
Service d'ORL et de chirurgie cervico-faciale, hôpital C. Huriez, CHRU de Lille, Place de Verdun, 59000 Lille, France.
Darras
J
J
Chevalier
D
D
Mortuaire
G
G
D005938:Glucocorticoids / Q000627:therapeutic use*; D006470:Hemorrhage / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007828:Laryngoscopy / Q000379:methods; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures; D011239:Prednisolone / Q000627:therapeutic use*; D011300:Preoperative Care; D011446:Prospective Studies; D016896:Treatment Outcome
D005938:Glucocorticoids; D011239:Prednisolone