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Postoperative irrigation therapy after sinonasal tumor surgery. | LitMetric

AI Article Synopsis

  • Sinonasal care after endoscopic tumor resection focuses on managing issues like crusting and mucus, with high-volume irrigations proving helpful; however, the impact of adding corticosteroids remains unclear.
  • A study compared the effects of saline versus saline with corticosteroid irrigation (betamethasone) on nasal symptoms and healing in patients post-surgery, analyzing results at 3 months post-operation.
  • The results showed no significant difference in healing scores between the two groups, but patients using saline alone reported lower nasal symptoms and better quality of life compared to those with the corticosteroid addition, suggesting corticosteroids might not be necessary after tumor resection.

Article Abstract

Background: Sinonasal care after endoscopic tumor resection aims to manage crusting, edema, mucus, and a healing cavity. High-volume irrigations have proved beneficial in this setting. The addition of corticosteroid to the irrigation is used for chronic rhinosinusitis (CRS) in modifying the postsurgical inflammatory response; however, its effect in endoscopic sinonasal tumor resection is unknown. Saline alone versus combination saline and corticosteroid irrigations in postoperative nasal care of sinonasal tumor patients was assessed.

Methods: A retrospective cohort of patients postendoscopic endonasal tumor resection was assessed. Patients used 240 mL of saline or 240 mL of saline with 1 mg of betamethasone daily. Nasal symptom scores (NSSs) and the 22-item Sino-Nasal Outcome test (SNOT-22) was recorded 3 months postoperatively. An endoscopic score was made of the area undergoing secondary healing at 3 months by two blinded assessors.

Results: Fifty-nine patients were assessed (aged 50.1 ± 18.26 years; 36% female subjects). The groups were similar in number (saline n = 31), treatment, and surgical characteristics. The endoscopic scores did not differ between the groups at 3 months. NSS was lower in the saline group (1.0 [interquartile range {IQR}, 3] versus 7.0 [IQR, 9]; p = 0.03) and, similarly, for SNOT-22 (0.24 [IQR, 1] versus 1.09 [IQR, 1]; p = 0.01) compared with the saline with steroid group.

Conclusion: Although corticosteroid irrigations have become routine for managing inflammatory sinus disease at our center, their use after tumor surgery does not appear to be warranted. The inflammatory healing process after tumor surgery differs from CRS inflammation and may explain the observed findings.

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Source
http://dx.doi.org/10.2500/ajra.2014.28.4009DOI Listing

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