Selective irrigation of paranasal sinuses in the treatment of recalcitrant chronic sinusitis.
BACKGROUND
Chronic rhinosinusitis (CRS) refractory to medical and surgical therapy is a challenging entity to treat. Topical antibiotics and anti-inflammatory drugs have been increasingly used in managing this disorder. The aim of this pilot study is to evaluate the role of maxillary sinus antrostomy tubes (MAST) in selectively irrigating paranasal sinuses with topical antibiotics with anti-inflammatory in treating recalcitrant CRS. A prospective clinical trial was performed at a tertiary referral center.


METHODS
Thirteen patients with failed maximal medical and surgical therapies for chronic sinusitis were enrolled in the study. Endoscopic scores as well as the Sino-Nasal Outcome Test 16 (SNOT-16) scores were obtained before and 3, 8, and 16 weeks after maxillary sinus intubation with MAST. All patients received topical antibiotics with anti-inflammatory medication for 21 days.


RESULTS
Statistically significant reductions in SNOT-16 and endoscopic scores were found before and after topical irrigations. Both scores continued to improve at the 8th and 16th weeks.


CONCLUSIONS
Selective irrigation of maxillary sinuses using MAST is a viable alternative in treating recalcitrant CRS.
Department of Otolaryngology, University of Toronto, Canada. moshaver@yahoo.com
Ali
A
Moshaver
Louis
L
Velazquez-Villasenor
Francois
F
Lavigne
Ian J
IJ
Witterick
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses; D010865:Pilot Projects; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*; D007507:Therapeutic Irrigation / Q000379:methods*
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents