title: Postoperative care for Samter's triad patients undergoing endoscopic sinus surgery: a double-blinded, randomized controlled trial.
abstract: OBJECTIVE
  Evidence is lacking to guide the postoperative management of Samter's triad patients with chronic rhinosinusitis with polyposis (CRSwP) undergoing endoscopic sinus surgery (ESS). The purpose of this study was to compare three different standardized medication regimens prescribed to these patients after ESS.
  
  
  METHODS
  Three-arm, randomized, double-blinded, controlled trial.
  
  
  METHODS
  Patients with Samter's triad undergoing ESS were postoperatively randomized into three medication regimens, those being saline irrigation alone (control group A), saline irrigation plus separate budesonide nasal spray (group B), and saline irrigation mixed with budesonide nasal spray (group C). Outcome measures were Sino-Nasal Outcome Test scores, Lund-Mackay computed tomography scores, and Lund-Kennedy endoscopic scores taken at preoperative baseline, and then at 6 months and 1 year postoperatively. Side effect profiles were also measured (adrenocorticotropic hormone blood level ranges and intraocular pressure at the same interval points). Analysis of variance and χ(2)  analyses were conducted using a Bonferroni correction method and routine descriptive statistics. Inter- and intragroup comparisons were made.
  
  
  RESULTS
  Sixty subjects were recruited. All groups were equivalent at baseline in all outcomes. All intragroup analyses showed statistically and clinically significant improvement in disease status as compared to baseline (P < .0167), with a sustained but lessened improvement at 1 year. However, no statistically or clinically significant differences were observed between groups at any time point (P > .05). There was no treatment effect noted.
  
  
  CONCLUSIONS
  In this study, nasal steroids did not confer any additional benefit over saline alone as post-ESS care for the Samter's triad CRSwP patient population.
authors: Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. brian.rotenberg@sjhc.london.on.ca
authors: Brian W
authors: BW
authors: Rotenberg
authors: Irene
authors: I
authors: Zhang
authors: Ian
authors: I
authors: Arra
authors: Keith B
authors: KB
authors: Payton
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D019819:Budesonide / Q000627:therapeutic use*; D004311:Double-Blind Method; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055556:Nasal Lavage / Q000379:methods; D010256:Paranasal Sinuses / Q000503:physiopathology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D012016:Reference Values; D012220:Rhinitis / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery*; D012965:Sodium Chloride / Q000494:pharmacology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012965:Sodium Chloride; D019819:Budesonide