Naslov
Oral steroid vs. topical furosemide . a controlled clinical trial of short-term preoperative treatment in nasal polyposis

Autori
Kalogjera, Livije ; Kroflič, Božidar ; Coer, Andrej

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstract Book of XXIII EAACI Congress ; The young investigator at the frontiers of allergy / Gerth van Wijk, Roy ; Frew, Anthony ; Groot, Hans - Amsterdam : DocumediaS, 2004

Skup
XXIII EAACI Congress

Mjesto i datum
Amsterdam, Nizozemska, 12.06.2004. - 16.06.2004

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
nasal polyposis; furosemide; steroid; eosinophil; mastocyte

Sažetak
Background. Short-term preoperative treatment with oral steroid is a golden standard in surgical treatment of nasal polyposis . Significant reduction of nasal polyp size following longer term (4-12 weeks) oral steroid treatment has been demonstrated. Topical application of furosemide significantly protects the polyp recurrence, and the effect on polyp size reduction was demontrated in case-controlled trials. The aim of the study was to evaluate the effect of topical furosemide on subjective nasal symptoms score, endoscopy polyp size scores, eosinophils, mastocyte infiltration and edema in the polyp tissue and compare it to oral steroid treatment. Methods. A group of 40 patients with nasal polyposis, following informed consent, approved by Ehtical Commitee, were randomized and allocated to treatment with 1mg/kg/day methylprednisolone orally or inhalation of 20mg/day furosemide for 7 days. Prior to treatment patients filled in subjective nasal symptoms scores, polyp size was scored by endoscopy and most superficial polyp was biopted. After 7-day treatment, patients were taken subjective and endoscopy scores and were operated in endotracheal anesthesisa (polypectomy and ESS). The most superficial polyp was biopted at the operation. Polyps were fixed, embedded in paraffin and stained by HE and tryptase. Eosinophils and mastocytes were counted in 10 high power fields and edema was measured as the distance from the surface to the closest gland. Results. Subjective scores were significantly improved in both groups, with no significant difference between the groups in any symptom, although olfaction was much better improved in the steroid group. Endoscopy scores were also significantly improved, with no difference between the groups. Steroid group had significant decrease in eosinophil count/HPF, with insignificant increase in edema i mastocyte count. Furosemide did not reach any significant change in cell count (decrease in mastocyte, increase in eosinophils), but edema was reduced almost significantly (p<0, 07). Conclusion. Preoperative reduction of nasal polyp size comparing oral steroid and topical furosemide has not found significantly different. Steroid is obviously acting antiinflammatory, as demonstrated by significant drop in eosinophils in polyp tissue, while furosemide has not demonstrated any antiinflammatory properties, and polyp reduction is likely achieved by edema reduction, acting on Na-K pump on the cellular membrane.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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