The effect of an absorbable gelatin dressing impregnated with triamcinolone within the olfactory cleft on polypoid rhinosinusitis smell disorders.
BACKGROUND
Chronic rhinosinusitis (CRS) is an inflammatory process that causes different clinical symptoms: nasal blockage and congestion, posterior and anterior nasal drip, and smell disorder ranging from reduced olfaction (hyposmia) to complete loss of smell (anosmia). It has been suggested that mechanical blockage of olfactory clef after polypectomy is responsible for the persistent impairment of olfaction in some cases. The aim of this study was to evaluate the efficacy of application of steroids at the olfactory cleft in improving olfactory function in patients who underwent sinus surgery.


METHODS
A double-blind, randomized controlled trial was conducted in Yazd, Iran, between March and December 2012. Eligible patients who had CRS with polyposis and underwent functional endoscopic sinus surgery were recruited. An absorbable gelatin dressing combined with triamcinolone (case) or normal saline (control) was applied at the site of surgery. Olfaction was assessed by butanol threshold tests before and 8 weeks after surgery.


RESULTS
A total of 60 patients were enrolled into the study and were equally divided into triamcinolone and control groups. Subjects in both arms of trial experienced augmentation of smell function throughout the study; however, patients who received triamcinolone had better improvement after 8 weeks (p = 0.007). Complete remission rate was 100% in the triamcinolone group and the corresponding figure was 76% in the control group.


CONCLUSIONS
We suggest that application of triamcinolone at the olfactory cleft can boost the effect of surgery in restoring olfactory function.
Department of Otolaryngology-Head and Neck Surgery, Shahid Sadoughi University of Medical Science, Yazd, Iran.
Mohammad Hossein
MH
Bardaranfar
Zahra
Z
Ranjbar
Mohammad Hossein
MH
Dadgarnia
Saeid
S
Atighechi
Abbas
A
Mirvakili
Nasim
N
Behniafard
Masoumeh
M
Sadeghi
Fatemeh
F
Abbaslu
Amin
A
Baradaranfar
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage*; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000628:therapy*; D009666:Nose / Q000187:drug effects* / Q000601:surgery; D009779:Occlusive Dressings / Q000706:statistics & numerical data; D000857:Olfaction Disorders / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D020127:Recovery of Function; D012074:Remission Induction; D012220:Rhinitis / Q000150:complications / Q000628:therapy*; D012852:Sinusitis / Q000150:complications / Q000628:therapy*; D012903:Smell / Q000187:drug effects; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage* / Q000009:adverse effects
D000893:Anti-Inflammatory Agents; D014221:Triamcinolone