Macrolide therapy on nasal mucosal persistent refractory inflammation after endoscopic sinus surgery
10.3760/cma.j.issn.1673-0860.2011.09.004
- VernacularTitle:大环内酯类药物治疗内镜鼻窦手术后黏膜迁延性炎性反应的临床观察
- Author:
Ke-Jun ZUO
1
;
Geng XU
Author Information
1. 中山大学附属第一医院,耳鼻咽喉科医院
- Keywords:
Macrolides;
Sinusitis;
Otorhinolaryngologic surgerical procedures;
Inflammation;
Treatment outcome
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2011;46(9):718-722
- CountryChina
- Language:Chinese
-
Abstract:
Objective To examine the clinical effect of low-dose (250 mg/d), long-term ( 12 -28 weeks) macrolide Klacid on the persistent refractory inflammation of paranasal sinus mucosa following endoscopic sinus surgery (ESS). Methods Thirteen patients from a consecutive series of 141 patients undergoing ESS for chronic rhinosinusitis ( CRS ) during 2004 - 2006 for the first time were recruited for persistent refractory inflammation over 2 years postoperatively. All patients were given Klacid 250 mg/d orally for 12 - 28 weeks and simultaneously maintained the usual treatment including intranasal corticosteroid, mucolytics, and nasal douche. At the end of treatment and the sequential 3 and 6 months,13 patients were evaluated by symptoms of visual analogue scale and nasal endoscopy by Lund-Kennedy scoring system, respectively. Results Among the 13 patients, 1 patient stopped therapy for no obvious benefit 5 months after treatment, 12 patients finished the planned treatment till achieving.the stopping therapy standard. Ultimately both symptom (8. O0 [ 7.50, 8.50]and 1.00 [ 0.25, 1. 00], Z = - 3.201, P ＜0.01) and endoscopic evaluation (7.00[6.50, 8.00]and 1.00[0.00, 1.00], Z= -3. 194, P＜O. 01 ) showed total remarkable improvement after therapy in 13 patients. The comprehensive assessment showed very good outcomes in 6 cases, good in 6 cases, and no good outcomes in 1 case, respectively.During the sequential 3 months and 6 months, no recurrent sinusitis and side effect happened in any patients. Conclusions It is effective to treat chronic refractory sinusitis with a low-dose (250 mg/d), long-term ( 12 -28 weeks) Klacid on nasal mucosal persistent refractory inflammation after ESS. Klacid is well tolerated and safe to CRS patients during the use of 12 -28 weeks.
