The effect of anatomically directed topical steroid drops on frontal recess patency after endoscopic sinus surgery: a prospective randomized single blind study.
BACKGROUND
The failure rate for frontal sinusotomy is higher than that of overall endoscopic sinus surgery (ESS). To prevent frontal sinus obstruction, systemic or topical steroids are commonly used, but systemic steroid therapy can cause significant morbidity and topical sprays can not be distributed to the frontal ostium. This study was designed to determine the efficacy of anatomically directed topical steroid drops in reducing frontal ostium stenosis compared with topical steroid sprays after ESS.


METHODS
A prospective, randomized, single-blind study was conducted in 43 patients (77 nasal cavities) who had undergone ESS, including frontal sinusotomy. Twenty-one patients (39 nasal cavities) used steroid drops applied with the Mygind technique, and 22 patients (38 nasal cavities) used steroid sprays for 8 weeks postoperatively. The patency of the frontal ostium was evaluated endoscopically 3 months postoperatively.


RESULTS
The study included 29 men and 14 women (mean age, 48.2 years; range, 19-62 years). Endoscopic scores in terms of polypoid change, edema, and scar in the middle meatus and frontal recess were not significantly different between the groups, although the drop group showed a tendency to superior scores when compared with the spray group (p > 0.05). The frontal sinus patency of the drop group was significantly higher than of the spray group (p < 0.05).


CONCLUSIONS
Topical steroid drops using the Mygind technique led to a 16% improvement in frontal sinus patency rates in 3 month after ESS in this study compared with postoperative topical steroid use.
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sang Duk
SD
Hong
Jeon Yeob
JY
Jang
Joon Ho
JH
Kim
Seong Yun
SY
Jang
Hyo Yeol
HY
Kim
Hun-Jong
HJ
Dhong
Seung-Kyu
SK
Chung
D000328:Adult; D016503:Drug Delivery Systems / Q000379:methods; D004724:Endoscopy; D005260:Female; D005626:Frontal Sinus / Q000033:anatomy & histology / Q000187:drug effects* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000188:drug therapy* / Q000601:surgery; D059085:Nasal Sprays; D011446:Prospective Studies; D016037:Single-Blind Method; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
D059085:Nasal Sprays; D013256:Steroids