title: Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis.
abstract: Chronic rhinosinusitis (CRS) is a common condition and affects the quality of life of approximately 16 % of adults in US and 10.9 % in Europe. Hyaluronan (HA) is a nonsulphate glycosaminoglycan found in the extracellular matrix of connective tissues, and plays an important role in the healing process and repair of mucosal surfaces. We aim to evaluate the effect of HA on nasal symptoms and endoscopic appearance in patients with CRS and nasal polyps (NP) who have not undergone sinus surgery. Eighty patients older than 18 years old were randomized to receive either open-label nebulized saline solution (NS) or intranasal corticosteroid spray (ICS) 200 µg bid or nebulized sodium hyaluronate (NHA, YABRO(®)) or both ICS and NHA. Results were collected at 1 month, 3 months and 3 months after treatment. Significant improvements in nasal symptoms scores, endoscopic appearance scores, radiologic scores, rhinomanometry and saccharine clearance test were observed in the NHA, ICS and ICS + NHA groups after 1 month and 3 months of treatment compared with baseline (all p ≤ 0.005). The use of oral steroids was significantly reduced after 3 months of therapy in the same groups versus baseline (all p < 0.05). The incidence of adverse events at 3 months was similar between the 4 groups (all p > 0.05). Throat irritation, nasal burning and drug-related epistaxis were not reported in the group NHA. HA, as a nebulized nasal douche preparation, improved nasal symptoms and endoscopic appearances in patients with CRS and NP who have not undergone sinus surgery.
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Cassandro
authors.affiliation: Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, University "Magna Graecia", Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Chiarella
authors.affiliation: "San Giovanni di Dio e Ruggi D'Aragona" Hospital, Salerno, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cavaliere
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Sequino
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cassandro
authors.affiliation: Gruppo Otologico, Casa Di Cura 'Piacenza', 42, Via Emmanueli, Piacenza, 29121 Italy.
authors.forename: Sampath Chandra
authors.initials: SC
authors.lastname: Prasad
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Scarpa
authors.affiliation: "San Giovanni di Dio e Ruggi D'Aragona" Hospital, Salerno, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Iemma
keywords: Chronic rhinosinusitis; Glycoaminoglycans; Hyaluronan; Hyaluronic; Nasal polyposis; Randomized; Rhinomanometry; YABRO®