Preoperative Short-Term Oral Glucocorticoid For Chronic Rhinosinusitis With Nasal Polyps:Subjective Evaluation And CT Observation

Objective: CRSwNP is a common refractory disease in otolaryngology.Although foreign literatures have reported that oral glucocorticoid can improve subjective and objective symptoms in patients with CRSwNP,there are few domestic related studies.At present,the perioperative treatment effect and timing of oral glucocorticoid therapy are still controversial.Therefore,this study mainly observed the changes of VAS score and Lund-Mackey sinus CT score before and after short-term oral glucocorticoid treatment and evaluated the subjective symptoms and imaging changes of short-term oral glucocorticoid treatment for CRSwNP before surgery.Methods: 27 patients with CRSwNP were included in this retrospective study.All patients were given methylprednisolone 24mg/d morning start,and the average course of treatment was(5.82±1.08)days from oral administration to endoscopic sinus surgery.VAS score and CT score of nasal sinuses were performed before and after treatment,and objective and subjective efficacy and adverse drug reactions during treatment were recorded.Subjective efficacy and sinus CT changes of short-term oral glucocorticoid treatment of CRSwNP were evaluated by means of self-control before and after treatment.Results: The average VAS score of the 27 patients after treatment was 4.37±1.80,significantly lower than 7.56 ±0.75 before treatment(P < 0.05).According to the subjective efficacy criteria,3 cases were cured(11.1%),18 cases were improved(66.7%),6 cases were ineffective(22.2%),and 21 cases were effective(77.8%).2.The average CT score of the sinus after treatment was 14.74±5.12,significantly lower than 18.81±3.70(P < 0.05).CT scores of the maxillary sinus,anterior ethmoid sinus,posterior ethmoid sinus,sphenoid sinus,frontal sinus and ostiomeatal complex were all significantly lower than those before treatment(P < 0.05).According to CT score of sinus,1 case(3.7%)was cured,22 cases(81.5%)were improved,4 cases(14.8%)were ineffective,and 23 cases(85.2%)were effective(cured + improved).3.There was no significant correlation between VAS score and Lund-Mackey sinus CT score before and after treatment(P>0.05).4.27 patients during oral glucocorticoid therapy,no adverse reactions or side reactions were found.Conclusion: Short-term oral glucocorticoid therapy in patients with CRSwNP,VAS score and Lund-Mackey sinus CT score were significantly improved.