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The effects of nasal lavage with betamethasone cream post-endoscopic sinus surgery : clinical trial

Dawson, Blake; Gutteridge, I.; Cervin, A. LU and Robinson, D. (2018) In Journal of Laryngology and Otology 132(2). p.143-149
Abstract

Background: Steroid nasal irrigation for chronic rhinosinusitis patients following endoscopic sinus surgery reduces symptom recurrence. There are minimal safety data to recommend this treatment. This study evaluated the safety of betamethasone nasal irrigation by measuring its impact on endogenous cortisol levels. Methods: Participants performed daily betamethasone nasal irrigation for six weeks. The impact on pre- and post-intervention serum and 24-hour urinary free cortisol was assessed. Efficacy was evaluated using the 22-item Sino-Nasal Outcome Test. Results: Thirty participants completed the study (16 females and 14 males; mean age = 53.9 ± 15.6 years). Serum cortisol levels were unchanged (p = 0.28). However, 24-hour urinary free... (More)

Background: Steroid nasal irrigation for chronic rhinosinusitis patients following endoscopic sinus surgery reduces symptom recurrence. There are minimal safety data to recommend this treatment. This study evaluated the safety of betamethasone nasal irrigation by measuring its impact on endogenous cortisol levels. Methods: Participants performed daily betamethasone nasal irrigation for six weeks. The impact on pre- and post-intervention serum and 24-hour urinary free cortisol was assessed. Efficacy was evaluated using the 22-item Sino-Nasal Outcome Test. Results: Thirty participants completed the study (16 females and 14 males; mean age = 53.9 ± 15.6 years). Serum cortisol levels were unchanged (p = 0.28). However, 24-hour urinary free cortisol levels decreased (47.5 vs 41.5 nmol per 24 hours; p = 0.025). Sino-Nasal Outcome Test scores improved (41.13 ± 21.94 vs 23.4 ± 18.17; p < 0.001). The minimal clinical important difference was reached in 63 per cent of participants. Conclusion: Daily betamethasone nasal irrigation is an efficacious treatment modality not associated with changes in morning serum cortisol levels. The changes in 24-hour urinary free cortisol levels are considered clinically negligible. Hence, continued use of betamethasone nasal irrigation remains a viable and safe treatment option for chronic rhinosinusitis patients following functional endoscopic sinus surgery.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Betamethasone, Chronic Rhinosinusitis, Cortisol, Endoscopic Sinus Surgery, Nasal Lavage
in
Journal of Laryngology and Otology
volume
132
issue
2
pages
143 - 149
publisher
Cambridge University Press
external identifiers
  • scopus:85042471285
ISSN
0022-2151
DOI
10.1017/S0022215117001827
language
English
LU publication?
yes
id
4b0a604c-732e-448f-8a81-d6047aa6260e
date added to LUP
2018-03-15 16:20:34
date last changed
2018-05-29 10:00:59
@article{4b0a604c-732e-448f-8a81-d6047aa6260e,
  abstract     = {<p>Background: Steroid nasal irrigation for chronic rhinosinusitis patients following endoscopic sinus surgery reduces symptom recurrence. There are minimal safety data to recommend this treatment. This study evaluated the safety of betamethasone nasal irrigation by measuring its impact on endogenous cortisol levels. Methods: Participants performed daily betamethasone nasal irrigation for six weeks. The impact on pre- and post-intervention serum and 24-hour urinary free cortisol was assessed. Efficacy was evaluated using the 22-item Sino-Nasal Outcome Test. Results: Thirty participants completed the study (16 females and 14 males; mean age = 53.9 ± 15.6 years). Serum cortisol levels were unchanged (p = 0.28). However, 24-hour urinary free cortisol levels decreased (47.5 vs 41.5 nmol per 24 hours; p = 0.025). Sino-Nasal Outcome Test scores improved (41.13 ± 21.94 vs 23.4 ± 18.17; p &lt; 0.001). The minimal clinical important difference was reached in 63 per cent of participants. Conclusion: Daily betamethasone nasal irrigation is an efficacious treatment modality not associated with changes in morning serum cortisol levels. The changes in 24-hour urinary free cortisol levels are considered clinically negligible. Hence, continued use of betamethasone nasal irrigation remains a viable and safe treatment option for chronic rhinosinusitis patients following functional endoscopic sinus surgery.</p>},
  author       = {Dawson, Blake and Gutteridge, I. and Cervin, A. and Robinson, D.},
  issn         = {0022-2151},
  keyword      = {Betamethasone,Chronic Rhinosinusitis,Cortisol,Endoscopic Sinus Surgery,Nasal Lavage},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {143--149},
  publisher    = {Cambridge University Press},
  series       = {Journal of Laryngology and Otology},
  title        = {The effects of nasal lavage with betamethasone cream post-endoscopic sinus surgery : clinical trial},
  url          = {http://dx.doi.org/10.1017/S0022215117001827},
  volume       = {132},
  year         = {2018},
}