title: Effect of Topical Furosemide on Rhinosinusal Polyposis Relapse After Endoscopic Sinus Surgery: A Randomized Clinical Trial.
abstract: Evidence from previous studies suggests that furosemide may be effective in reducing the recurrence of polyps after sinus surgery. However, the evidence is limited and insufficient, and further investigations are required.
  
  
  
  To assess the effect of topical furosemide on recurrence rate of rhinosinusal polyposis after endoscopic sinus surgery.
  
  
  
  Triple-blind randomized clinical trial of patients aged 18 to 60 years with chronic rhinosinusitis associated with polyposis who did not respond to medical treatment and were candidates for endoscopic sinus surgery at Besat Hospital, Hamadan University of Medical Sciences, from April 2014 to June 2015.
  
  
  
  Patients were randomly assigned to receive postoperative nasal spray, 2 puffs twice a day for 2 months, either 300 µg of furosemide per day or placebo.
  
  
  
  Six months after surgery, the patients were examined for nasal and paranasal sinus polyposis using Meltzer endoscopic grading, computed tomographic (CT) scan of paranasal sinuses (PNS) scoring, Sino-Nasal Outcome Test (SNOT-22) scoring, and visual analog scale (VAS).
  
  
  
  Of 110 patients enrolled, 84 patients remained for analysis (53 men and 31 women; mean age in the furosemide group, 37.02 years, range, 18-58 years; mean age in the placebo group, 36.30 years, range, 18-60 years). Six months after the intervention, the grade of polyposis decreased in both groups, but this reduction was substantial in the furosemide group vs the placebo group. The severity of polyposis was significantly lower in the furosemide group vs the placebo group based on SNOT-22 scoring (difference, 8.05; 95% CI, 3.24-12.85) and VAS (difference, 0.81; 95% CI, 0.22-1.39) but not significantly different based on CT scan of PNS scoring (difference, 2.52; 95% CI, -0.35 to 5.39). The incidence of adverse effects (nasal irritation, headache, and constipation) were not significantly different between the 2 groups.
  
  
  
  These findings indicate that topical furosemide is a safe drug, with no important adverse effects, that can substantially reduce the severity of polyposis after endoscopic sinus surgery.
  
  
  
  Iranian Registry of Clinical Trials registration number: IRCT201403143186N5.
authors.affiliation: Otolaryngology-Head and Neck Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Farnaz
authors.initials: F
authors.lastname: Hashemian
authors.affiliation: Otolaryngology-Head and Neck Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Ghorbanian
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Farshad
authors.initials: F
authors.lastname: Hashemian
authors.affiliation: Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Alireza
authors.initials: SA
authors.lastname: Mortazavi
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Sheikhi
authors.affiliation: Otolaryngology-Head and Neck Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Javaneh
authors.initials: J
authors.lastname: Jahanshahi
authors.affiliation: Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran5Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Jalal
authors.initials: J
authors.lastname: Poorolajal
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010255:Paranasal Sinus Neoplasms / Q000628:therapy; D010256:Paranasal Sinuses; D055502:Secondary Prevention
chemical_list: D005665:Furosemide