Objectives: To determine the efficacy of a 7-day treatment of methylprednisolone 16mg in reducing the size of nasal polyps and on improvement of nasal symptoms. Methods: Design: Randomized double-blind placebo-controlled trial Setting: Out-patient department of the East Avenue Medical Center Patients: Patients 18 years old and above with nasal polyposis determined by history and endoscopic examination Results: There was a significant decrease in polyp size by an average of 16 percent (P < .05) among 12 out of the 23 patients (52.17 percent) in the steroid group versus placebo. The treatment group also exhibited an improvement in nasal symptoms of rhinorrhea, congestion and anosmia compared to the placebo. Conclusion: Medical treatment with oral methylprednisolone given at a low dose of 16 mg for one week resulted in reduction of the size of nasal polyps and improved the symptoms of rhinorrhea, nasal congestion and anosmia. Other associated symptoms like headache, epistaxis, sneezing, itchiness, epiphora, cough, postnasal drip, throat discomfort, facial pain, eyecomplaints and fever did not differ between the steroid and placebo groups. Recommendation: One week of oral steroids can be used to treat nasal polyps initially. If there is response, this mode of management can be combined with a long-term course of intranasal steroid sprays. Patients who do not respond may be referred for surgery. (Author)
NOSE DISEASES METHYLPREDNISOLONE OLFACTION DISORDERS POLYPS NASAL POLYPS

OBJECTIVE: General objective: To compare the efficacy of chitosan solution impregnated nasal packing with normal saline solution impregnated nasal packing on wound healing of the nasal mucosa in rabbits (Oryctolagus cuniculus). Specific objective: To determine the difference between the effects of chitosan solution impregnated nasal packing compared with normal saline solution impregnated nasal packing on wound healing of the nasal mucosa in rabbits particularly on various aspects of wound healing as to epithelialization, vascularization, inflammation and fibrosis. DESIGN: Experimental design SETTING: Santo Tomas University Hospital MATERIALS AND METHODOLOGY: This study is a randomized double blind clinical study. After giving the rabbits Ketamine HCI about 0.3-0.5 mm square area of the floor of the nasal mucosa was excised and sent for histopathology for baseline studies. Impregnated nasal packings where placed on the wounds and removed after forty eight hours. After two weeks about 0.3-0.5 mm of nasal mucosa was harvested on both nostrils and sent to the pathologist for review. RESULTS: There were four parameters of wound healing that were evaluated in this study, namely epithelialization, vascularization, inflammation and fibrosis. A comparison of the effect of chitosan and NSS on wound healing were compared in each of these 4 parameters. Statistical tests showed that on the basis of epithelialization, chitosan was significantly better than that of NSS (p<0.05). Chitosan was also found to be significantly better than that of NSS in terms of inflammation (p<0.05) and ftbrosis (p<0.05). There was no difference noted however in the aspect of vascularization between chitosan and NSS (p>0.05). CONCLUSION: The chitosan solution impregnated nasal packing was found to be significantly better than the NSS solution impregnated naeal packing on three of the four parameters of wound healing that were evaluated in this study in terms of epithelialization, inflammation and fibrosis but there was no difference noted in the aspect of vascularization between chitosan and NSS solutions. (Author)
CHITOSAN WOUND HEALING NASAL MUCOSA RABBITS

OBJECTIVE: To evaluate the effects of Dexamethasone-impregnated absorbable nasal pack versus saline-impregnated nasal packing on postoperative outcome of nasal cavities after endoscopic sinus surgery using the Perioperative Sinus Evaluation Scoring System (POSE) and Lund and Kennedy Endoscopic Scoring System. 

METHODS:

Design: Prospective, randomized, double blinded, placebo-controlled trial

Setting: Single Center Tertiary Government Hospital

Participants: Nineteen (19) patients aged 15 years old and above, diagnosed with chronic rhinosinusitis, with nasal polyposis grade 3, who underwent endoscopic sinus surgery from January 2015 to August 2015 

RESULTS: Nasal cavities that received postoperative dexamethasone-impregnated nasal packs showed significantly lower POSE scores than placebo on post-op Days 14 (p value 0.0022; 95% CI: -2.113 to -0.5116) as well as lower Lund-Kennedy Scores on post-op day 14 (p value of 0.0180; 95% CI: -2.493 to - 0.2571) and day 28 (p value of 0.007; 95% CI: -1.56275 to -0.2832) 

CONCLUSION: Dexamethasone-impregnated absorbable nasal packing affords better postoperative outcomes: less edema, crusting, secretions, and synechiae, than saline-impregnated absorbable packing in later postoperative days.

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Dexamethasone ; Endoscopy ; Nasal Cavity