The Therapeutic Effect Of Intranasal Corticosteroids Of Post-endoscopic Surgery On Chronic Rhinosinusitis With Nasal Polyp

The therapeutic effect of intranasal corticosteroids of post-endoscopic surgery on chronic rhinosinusitis with nasal polypBackground: The relationship between recurrence of CRSwNP of post-endoscopic surgery and nasal structural rechanges (remodeling) is unclear. Diagnosis and treatment guidelines of chronic rhinosinusitis and nasal polyp( 2008, Nanchang ) recommended treating CRSwNP with intranasal corticosteroids on perioperative period and at least 12 weeks postoperation.Objectives: To evaluate the subjective symptom improve and the role of preventing recurrence following treatment of intranasal corticosteroids spray, also analyse effects of the nasal mucosal remodeling with the therapy in histomorphology on CRSwNP after FESS.Methods: 61patients from January 2009 to June 2010 of CRSwNP after FESS were randomly divided into intranasal corticosteroids group (34 cases) and contorl group(27 cases). Acording to the course of treatment all patients were splited into 3 months, 6 months and 12 months treatment group. In review, we evaluated nasal symptomes improving via VAS scores, checked nasal mucosa recovering with endoscopy and consulted Lund-Kennedy marking system to rating. The tissue sample slides membrane takend by endscopic were stained by hematoxylin-and-eosin(H&E) staing for derermining eosinophilial infiltration and shedding of the epithelium, alcian blue-periodic acid-Schiff (AB-PAS) staining for evaluating goblet cell and subepithelial gland, Masson's Trichrome (MT) staining for observing subepithelial collagen fiber deposition.Results: Improving subjective symptoms and the recovery of nasal mucosa of the patients in steroid group were significant compared to control group. Infiltrated eosinophils of histologic specimens from intranasal corticosteroids group were significantly decreased, also recovering of epithelial damage and inhibition of reborning of collagenous fiber had different changes between in steroid and control group.Conclusions: Through the long-term clinical tracking, intranasal corticosteroids in post operative treatment of persistant rhinosinusitis improved nasal symptoms and may prevent recurrences of NP, which may plays an important role in blocking nasal mucosa tissue remodeling after FESS.