A Comparative Study on the Efficacy of Budesonide versus Saline Nasal Irrigation in Post Endoscopic Sinus Surgery of Patients with Rhinosinusitis

Abstract

Background and Objective:Nasal irrigation with normal saline is an important role in rhinosinusitis. However, few reports of Thailand have examined whether its use for normal saline nasal irrigations (NNI) compared with budesonide nasal irrigations (BNI). This study aimed to compare the efficacy of BNI versus NNI in post endoscopic sinus surgery (ESS) of patients with rhinosinusitis (RS).

Methods: Sixty-six RS patients who had post ESS were randomly divided into an experimental group (33patients), which used BNI, and a control group (33patients), which used NNI. All patients received regular follow-up evaluations and were assessed via questionnaires, including the lund–kennedy endoscopic score (LKES), the symptom visual analog scale (VAS) and Thai sinonasal outcome test-22 (Thai SNOT-22). Patients were followed up post-ESS at 2, 4 and 12 weeks.  Pearson chi-square test, Student t-test and Wilcoxon rank-sum test were used for statistical analysis.

Results: BNI group showed statistical significant improvements at 2,4 and 12 weeks after ESS.  scores of LKES  better than in NNI (p=0.005, p=0.010, p=0.009). At 12 weeks after ESS, scores of polyp and edema and total score of LKES in BNI group were significantly better than in NNI group (p=0.001, p=0.022), The median scores of VAS: 7 (IQR 3-9) vs 3 (IQR 1-5)  and Thai SNOT-22 : 20 (IQR 10-24)  vs  11 (IQR 7-15) in the NNI and BNI groups respectively, showed significant differences between 2 groups (p=0.001, p=0.001)

Conclusion: Budesonide in saline sinonasal irrigations improved nasal symptoms and reduce polyp and edema grading more effective than saline nasal irrigation alone.