title: Topical gel therapy for sinonasal polyposis in Samter's triad: preliminary report.
abstract: OBJECTIVE
  Rhinosinusitis and polyposis are difficult to treat in patients with Samter's triad; they commonly recur despite sinus surgery, antibiotics, and/or nasal steroids. The present study assesses the efficacy of a multimodal regimen that includes topical corticosteroids and antibiotics delivered through a hydroxyethyl cellulose gel and by nebulization.
  
  
  METHODS
  Eleven patients with Samter's triad who had polyposis and rhinosinusitis that recurred despite endoscopic sinus surgery were treated with a 6-week course of multimodal topical therapy consisting of a hydroxyethyl cellulose gel that releases corticosteroids and antibiotics, topical nebulization of corticosteroids and antibiotics, saline solution rinses, and sinus debridement. Clinical outcomes were evaluated by Lund-Kennedy endoscopic and symptom scores. Histologic assessment was evaluated by hematoxylin and eosin staining before and after treatment.
  
  
  RESULTS
  Both Lund-Kennedy symptom and endoscopic scores showed.a progressive and statistically significant decline throughout the course of treatment, reaching at 6 weeks 42% of the pretreatment values (p = 0.005) for the Lund-Kennedy symptom score and 34% (p = 0.002) for the endoscopic score, respectively; however, the significance of the improvement was lost with time.
  
  
  CONCLUSIONS
  Topical gel therapy improves clinical symptoms, endoscopic findings, and sinus membrane histologic features in patients with refractory Samter's triad, but the improvement is transient, suggesting that a longer therapeutic period might be needed.
authors.affiliation: Division of Rhinology, Dept of Otolaryngology-Head and Neck Surgery, Union Memorial Hospital, 201 E University Pkwy, Baltimore, MD 21218, USA.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Shikani
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kourelis
authors.forename: Ziad
authors.initials: Z
authors.lastname: Rohayem
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Basaraba
authors.forename: Jeff G
authors.initials: JG
authors.lastname: Leid
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001241:Aspirin; D001249:Asthma / Q000209:etiology / Q000473:pathology; D003646:Debridement; D004342:Drug Hypersensitivity / Q000209:etiology / Q000473:pathology; D004724:Endoscopy; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D009298:Nasal Polyps / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D011244:Pregnadienediols / Q000008:administration & dosage*; D012220:Rhinitis / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D012852:Sinusitis / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005782:Gels; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D001241:Aspirin