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The effect of corticosteroids in patients with nasal polyposis and asthma
Research Posters
ions on nasal epithelium by steroids as shown in this study would contribute to the alleviation of the clinical symptoms by way of suppressing the hypersecretion of the patients suffering from allergic rhinitis. Support: None reported.
R131 The Effect of Corticosteroids in Patients with Nasal Polyposis and Asthma Ferran Ballesteros; Pedro A. Benitez, PhD;
MD PhD;
Isam Alobid,
MD
Cesar Picado, MD; Joaquim Mullol, MD PhD
Barcelona
Spain;
Badalona
Spain;
Barcelona
Spain;
Barcelona Spain; Barcelona Spain
Problem: Nasal polyps (NP) were observed in 10% of patients with asthma. The effect of intranasal corticosteroids (ICS) in patients with asthma remains controversial in the actual literature. The purpose of this study was to evaluate the effect of ICS and oral corticosteroids (OCS) regarding lung function and polyp size in patients with or without asthma. Methods: After 4 weeks of washout period of ICS and OCS all patients were included in this study. Forty patients with NP (14 without asthma, 26 with asthma of which 13 had aspirin-tolerant and 13 aspirin-sensitive asthma. All patients were treated with oral prednisone (30 mg daily for 4 weeks, followed by 2 days’ reduction of 5 mg) and intranasal budesonide (400 `ıg/twice a day). Before starting the treatment, at 2 following weeks and finally at the 12th week, polyp size (measured by nasal endoscopy) and lung function (measured by peak flow) were evaluated. Results: Patients with NP with or without asthma showed basal values lower than the standard pattern for gender and age. Spiratory peak flow (SPF) in patients with aspirin-sensitive asthma improved with OCS (398 ⫾ 123 L/min, P ⬍ 0.05) and ICS (451 ⫾ 140, P ⬍ 0.05) in reference to the basal values (368 ⫾ 138). In the group with aspirin tolerant asthma the only improvement was with ICS (477 ⫾ 113, P ⬍ 0.01) in reference to the basal values (413 ⫾ 97). Polyp size improved with both treatments in all groups (P ⬍ 0.01), but without any correlation with SPF. Conclusion: These results suggest that lung function improvement with ICS in patients with NP without asthma could be related to a minimal subclinic chronic inflammation activity of the lower airway. In the group of NP with aspirinsensitive asthma, this inflammation revealed the clinical findings observed in asthma. Significance: Patients diagnosed with simple nasal polyposis should prompt a search of asthma disease. Support: Hospital Clinic I Universitari De Barcelona, Barcelona.Spain
R132 The Relationship between Rhinosinusitis Symptoms and Mucociliary Clearance Time Justin E. Boatsman (presenter); Karen H Calhoun, MD; Matthew W Ryan, MD Galveston TX; Columbia MO; Galveston TX
Problem: To determine the correlation between rhinosinusitis symptoms as assessed by the SNOT-20 (SinoNasal Outcomes Test-20) survey and nasal mucociliary clearance time as assessed by the saccharin method. Methods: This was a cross-sectional study of volunteers at a tertiary care academic medical center. Fifty adult volunteers completed a SNOT-20 questionnaire as well as a brief questionnaire about other lifestyle or medical factors that might affect nasal function. Mucociliary clearance time was then assessed with the saccharine method. Correlation coefficients (Spearman’s Rho) were calculated for the global SNOT-20 score and individual domains. Results: The global SNOT-20 scores varied from 20 to 54 (mean, 30.28) with a possible range of 20 to 100. Saccharine clearance times varied from 418 to 2,865 seconds (mean, 999.) There was no significant correlation between SNOT-20 score and saccharine clearance time. The SNOT-20/clearance time correlation coefficient (Spearman Rho) was 0.196. There were no significant correlations between individual domain scores and mucociliary clearance time. Conclusion: There is no significant correlation between rhinosinusitis symptoms as assessed by SNOT-20 scores and mucociliary clearance time as assessed by the saccharine method. Significance: The mucociliary clearance function is important for the general health of the sinonasal cavities, but mucociliary clearance time does not appear to be associated with symptom severity in the population studied. Support: none R133 Pre- and Post-Treatment Mucociliary Function in Allergic Rhinitis in Three Modalities Lee Leong-Meng, MD; Raymond SK Tan (presenter); Yu-Hsiang Shu, BS; Chih-Jaan Tai, MD MSc Kuala Lumpur Malaysia; Kuala Lumpur Malaysia; Taipei Taiwan (Republic of China); Taichung Taiwan (Republic of China)
Problem: Mucociliary function is known to be impaired in perennial allergic rhinitis. Does treatment objectively improve this function? This study was aimed at assessing this question. Methods: A prospective randomized controlled study was performed using 3 different treatment modalities in 71 patients with allergic rhinitis, confirmed via a skin-prick test. Pre- and postmucociliary function was measured using the Saccharin Transport Time (STT) Test. The 3 treatment modalities were as follows: (1) intranasal beclomethasone spray
POSTERS
P194
Otolaryngology– Head and Neck Surgery August 2004
ions on nasal epithelium by steroids as shown in this study would contribute to the alleviation of the clinical symptoms by way of suppressing the hypersecretion of the patients suffering from allergic rhinitis. Support: None reported.
R131 The Effect of Corticosteroids in Patients with Nasal Polyposis and Asthma Ferran Ballesteros; Pedro A. Benitez, PhD;
MD PhD;
Isam Alobid,
MD
Cesar Picado, MD; Joaquim Mullol, MD PhD
Barcelona
Spain;
Badalona
Spain;
Barcelona
Spain;
Barcelona Spain; Barcelona Spain
Problem: Nasal polyps (NP) were observed in 10% of patients with asthma. The effect of intranasal corticosteroids (ICS) in patients with asthma remains controversial in the actual literature. The purpose of this study was to evaluate the effect of ICS and oral corticosteroids (OCS) regarding lung function and polyp size in patients with or without asthma. Methods: After 4 weeks of washout period of ICS and OCS all patients were included in this study. Forty patients with NP (14 without asthma, 26 with asthma of which 13 had aspirin-tolerant and 13 aspirin-sensitive asthma. All patients were treated with oral prednisone (30 mg daily for 4 weeks, followed by 2 days’ reduction of 5 mg) and intranasal budesonide (400 `ıg/twice a day). Before starting the treatment, at 2 following weeks and finally at the 12th week, polyp size (measured by nasal endoscopy) and lung function (measured by peak flow) were evaluated. Results: Patients with NP with or without asthma showed basal values lower than the standard pattern for gender and age. Spiratory peak flow (SPF) in patients with aspirin-sensitive asthma improved with OCS (398 ⫾ 123 L/min, P ⬍ 0.05) and ICS (451 ⫾ 140, P ⬍ 0.05) in reference to the basal values (368 ⫾ 138). In the group with aspirin tolerant asthma the only improvement was with ICS (477 ⫾ 113, P ⬍ 0.01) in reference to the basal values (413 ⫾ 97). Polyp size improved with both treatments in all groups (P ⬍ 0.01), but without any correlation with SPF. Conclusion: These results suggest that lung function improvement with ICS in patients with NP without asthma could be related to a minimal subclinic chronic inflammation activity of the lower airway. In the group of NP with aspirinsensitive asthma, this inflammation revealed the clinical findings observed in asthma. Significance: Patients diagnosed with simple nasal polyposis should prompt a search of asthma disease. Support: Hospital Clinic I Universitari De Barcelona, Barcelona.Spain
R132 The Relationship between Rhinosinusitis Symptoms and Mucociliary Clearance Time Justin E. Boatsman (presenter); Karen H Calhoun, MD; Matthew W Ryan, MD Galveston TX; Columbia MO; Galveston TX
Problem: To determine the correlation between rhinosinusitis symptoms as assessed by the SNOT-20 (SinoNasal Outcomes Test-20) survey and nasal mucociliary clearance time as assessed by the saccharin method. Methods: This was a cross-sectional study of volunteers at a tertiary care academic medical center. Fifty adult volunteers completed a SNOT-20 questionnaire as well as a brief questionnaire about other lifestyle or medical factors that might affect nasal function. Mucociliary clearance time was then assessed with the saccharine method. Correlation coefficients (Spearman’s Rho) were calculated for the global SNOT-20 score and individual domains. Results: The global SNOT-20 scores varied from 20 to 54 (mean, 30.28) with a possible range of 20 to 100. Saccharine clearance times varied from 418 to 2,865 seconds (mean, 999.) There was no significant correlation between SNOT-20 score and saccharine clearance time. The SNOT-20/clearance time correlation coefficient (Spearman Rho) was 0.196. There were no significant correlations between individual domain scores and mucociliary clearance time. Conclusion: There is no significant correlation between rhinosinusitis symptoms as assessed by SNOT-20 scores and mucociliary clearance time as assessed by the saccharine method. Significance: The mucociliary clearance function is important for the general health of the sinonasal cavities, but mucociliary clearance time does not appear to be associated with symptom severity in the population studied. Support: none R133 Pre- and Post-Treatment Mucociliary Function in Allergic Rhinitis in Three Modalities Lee Leong-Meng, MD; Raymond SK Tan (presenter); Yu-Hsiang Shu, BS; Chih-Jaan Tai, MD MSc Kuala Lumpur Malaysia; Kuala Lumpur Malaysia; Taipei Taiwan (Republic of China); Taichung Taiwan (Republic of China)
Problem: Mucociliary function is known to be impaired in perennial allergic rhinitis. Does treatment objectively improve this function? This study was aimed at assessing this question. Methods: A prospective randomized controlled study was performed using 3 different treatment modalities in 71 patients with allergic rhinitis, confirmed via a skin-prick test. Pre- and postmucociliary function was measured using the Saccharin Transport Time (STT) Test. The 3 treatment modalities were as follows: (1) intranasal beclomethasone spray
POSTERS
P194
Otolaryngology– Head and Neck Surgery August 2004