engleski

Impact of endonasal treatment on subjective outcomes and cellular marker level in allergic and nonallergic patients with chronic rhinosinusitis

Background: The aim of this study was to compare subjective symptoms in allergic and nonallergic patients with chronic rhinosinusitis and to evaluate the impact of endosinusal treatment on subjective outcomes in allergic and nonallergic patients with chronic rhinosinusitis. Methods: Thirty patients with symptoms of chronic rhinosinusitis lasting more than 3 months were recruited for the study. Fourteen (46.7%) patients were categorized as allergic and 16 (53.3%) as nonallergic. During the study, patients were treated with 2mg dexamethasone and 40mg gentamycine per maxillary sinus/day applied through a polyethylene anstrostomy tube for 5 days. Patients completed a self-administered questionnaire concerning sinusitis symptoms: obstruction, postnasal drip, headache, discharge, sneezing, facial swelling, cough, nasal itching, olfaction or taste disturbances, before intervention and at 1 month followup. Sinusitis symptoms scores are presented as the mean value of 10 symptom scores. Sinus lavage at inclusion and after 5-day treatment was analyzed for tryptase, ECP and MPO. Results: Significant improvement at day 30 was noted for overall sinusitis symptoms score (P50.02) and for obstruction, postnasal drip, headache, sneezing and cough (P o0.05) for the whole study group, other simptoms: nasal discharge, facial swelling, nasal itching, olfaction or taste disturbances did not show significant improvement at 1 month follow up. Significant improvement at day 30 was noted for overall sinusitis symptoms score in allergic group (P50.015), but not for nonallergic group (P50.06). There was significant difference between allergic and nonallergic group in overall pretreatment sinusitis symptom score and in pretreatment scores for nasal itching, olfaction and cough (Po0.05). There was no difference in overall post-treatment sinusitis symptom score and post-treatment sinusitis symptoms between allergic and nonallergic group. Tryptase level was decreased in both groups (Po 0.05), but decrease of ECP was shown only in allergic group, especially in asthmatic subgroup. MPO did not show significant decrease in both groups. Conclusion: Steroid/antibiotic endosinusal treatment is effective in reducing subjective sinusitis symptoms and decrease of certain cellular markers in patients with chronic rhinosinuitis, especially in allergic patients, and this treatment also decreases the difference in subjective scores between allergic and nonallergic patients.

symptoms; allergic rhinitis; nonallergic rhinitis

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