title: Effect of steroids for nasal polyposis surgery: A placebo-controlled, randomized, double-blind study.
abstract: OBJECTIVE
  Although medical intervention is the first option for treatment of nasal polyps, surgery is still a therapeutic option for symptomatic cases that do not respond or partially respond to medical intervention. However, there is a need for high-level evidence for the preoperative use of steroids in nasal polyposis surgery. We aimed to assess the perioperative effect of preoperative use of oral prednisolone for advanced-stage diffuse nasal polyposis.
  
  
  METHODS
  Prospective, double-blind, randomized, placebo-controlled study.
  
  
  METHODS
  A visual analog scale (VAS) was evaluated for smell, nasal discharge, nasal obstruction, facial pressure, headache, butanol smell threshold, and peak nasal inspiratory flow (PNIF) before and after the use of study drug. Perioperative bleeding volume, visibility of operative field, operative time, hospital stay, and complication rate were also evaluated.
  
  
  RESULTS
  The improvement in the corticosteroid group (CG) in the VAS scores, butanol thresholds, and PNIF values showed statistically significant differences compared to the placebo group (PG) (P < .05). The perioperative bleeding volume, visibility score, operative time, and hospital stay for CG/PG were 141 mL/384 mL, 2.4/3.4, 61 min/71.6 min, and 1.1 day/1.8 day, respectively (P < .05). The difference between the complication rates for the two groups did not show any statistically significant difference (P = .214).
  
  
  CONCLUSIONS
  Preoperative administration of systemic corticosteroids improves the perioperative visibility by reducing blood loss and shortens the operation time. We recommend the use of preoperative corticosteroid for the safety of the patients. The optimum dose and duration have not been established and require further studies.
  
  
  METHODS
  1b.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Mustafa Cenk
authors.initials: MC
authors.lastname: Ecevit
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Taner Kemal
authors.initials: TK
authors.lastname: Erdag
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Ersoy
authors.initials: E
authors.lastname: Dogan
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Semih
authors.initials: S
authors.lastname: Sutay
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D009298:Nasal Polyps / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D059747:Nasal Surgical Procedures / Q000379:methods*; D011239:Prednisolone / Q000008:administration & dosage*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012903:Smell; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone
keywords: N-butanol olfactory threshold; Nasal polyps; PNIF; complication; corticosteroids; double blind; endoscopic sinus surgery; operative bleeding; operative field visibility; randomized controlled trial