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Intensive Medical Treatment Can Improve Chronic Sinusitis
A DGReview of :"A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis."
American Journal of Rhinology
01/21/2003
By David Loshak
Intensive medical treatment of chronic sinusitis can bring symptomatic and radiographic improvement, allowing most patients to remain free of relapse for more than eight weeks following treatment.
Specialists from the Washington University School of Medicine, St. Louis, Missouri, observed that despite the high prevalence of chronic sinusitis, few published studies had assessed its response to medical treatment.
They analysed 40 patients who had received intensive medical therapy for chronic sinusitis and assessed their symptomatic and radiographic improvements plus factors associated with early relapse.
The intensive medical treatment consisted of one month of antibiotics, a short course of oral steroids and adjunctive therapy such as nasal irrigations plus intranasal steroids. This adjunctive treatment was continued after the intensive medical treatment.
A sinus computed tomography was performed at baseline and six to eight weeks later and scored for the extent of disease. Pre- and post-treatment symptom scores were also assessed.
Time to relapse was defined as how long it took after antibiotic treatment for a recurrence of symptoms which necessitated giving antibiotics and/or oral steroids again.
Of the 40 patients, 36 improved symptomatically, radiographically or both after the medical regimen and 26 had sustained symptomatic benefit beyond eight weeks.
There was a statistically significant correlation between the change from pre-treatment to post-treatment symptom scores and computed tomography scores.
The specialists said that nasal polyposis and a history of sinus surgery were significantly associated with earlier relapse, but atopy, asthma and persistent obstruction of the osteomeatal unit were not.
Although the specialists did not establish that there could be long-term benefits, they favoured a prospective study of outcomes from intensive medical treatment.
American Journal of Rhinology 2002;16(6):303-312.
"A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis."
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