ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Scant Data on Oral Corticosteroid Therapy for CRS Without Polyps

by James A. Stankiewicz, MD • September 2, 2011

  • Tweet
  • Email
Print-Friendly Version

How well do our non-polyp chronic rhinosinusitis patients do when treated with oral steroids as part of their medical therapy?

Background: Because we now look at chronic rhinosinusitis (CRS) as an inflammatory problem, the use of topical and oral corticosteroids becomes more important. Systematic evaluation of oral steroid use in CRS without nasal polyposis (CRSsNP) has not been done previously. The objective of this study was to review any evidence in the CRS literature.

You Might Also Like

  • Saline Irrigation Effective in Treating CRS
  • IT Steroid Treatment, Oral Corticosteroid Therapy Similar for Sudden Sensorineural Hearing Loss
  • Medical Therapy vs. Surgery for CRS
  • CMT Does Not Improve CRS after Adequate Medical Therapy Fails
Explore This Issue
September 2011

Study design: Ovid and PubMed databases searched for studies on oral steroid therapy for CRS with nasal polyps. All manuscripts were graded using evidence-based medicine (EBM) levels.

Setting: Academic medical center.

Synopsis: Out of 2,397 abstracts, 126 showed evidence of oral steroid use in CRS. Further review showed 33 studies, including 30 relating to CRSsNP and three relating to allergic fungal sinusitis (AFS). The CRSsNP studies did not include randomized controlled trials or clinical studies employing oral corticosteroids alone. Most studies with EBM levels of 4 or 5 consisted of review articles or expert opinion and should therefore be seen as data-weak recommendations for using oral steroids for CRSsNP. One level 3 prospective study involved the use of oral corticosteroids with antibiotics and topical steroids. The multi-drug regimen improved symptoms, radiologic findings, short-term relapses, nasal endoscopy and cytokine pattern expression. For AFS, a level 1 randomized controlled study and a level 3 prospective study found the use of oral corticosteroids beneficial in controlling postoperative recurrence with improved endoscopy and CT scan grade levels.

Bottom line: Oral corticosteroids have not been used alone in any study for CRSsNP; therefore, no data are available. Oral corticosteroids used in combination therapy with antibiotics and topical steroids do show improvement in symptoms, short-term relapses, control of AFS and improved endoscopy and radiologic grading levels. Unfortunately, all these studies have an EBM level of 4 or 5 and, as such, are minimally evidence based.

Citation: Lal D, Hwang PH. Oral corticosteroid therapy in chronic rhinosinusitis without polyposis: a systematic review. Int Forum Allergy Rhinol. 2011;1(2):136-143.

—Reviewed by James A. Stankiewicz, MD

Filed Under: Literature Reviews, Rhinology Tagged With: chronic rhinosinusitis, combination therapy, CRS, medical therapy, non-polyp chronic rhinosinusitis patients, oral steroidsIssue: September 2011

You Might Also Like:

  • Saline Irrigation Effective in Treating CRS
  • IT Steroid Treatment, Oral Corticosteroid Therapy Similar for Sudden Sensorineural Hearing Loss
  • Medical Therapy vs. Surgery for CRS
  • CMT Does Not Improve CRS after Adequate Medical Therapy Fails

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Weaning Patients Off of PPIs
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Did You Receive COVID-19 Relief? Here Are Reporting Considerations for 2021
    • Otolaryngology Experts Share Best Practices in Five Areas
    • How Climate Change May Be Affecting Sleep Patterns for Adults and Children
    • Laryngologists Discuss Tough Tracheostomy Choices During COVID-19 Era
    • Head and Neck Cancer: Experts Discuss How to Improve Surgery Quality and Value

Polls

Did you receive funding from the CARES Act or Paycheck Protection Program?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.