Steroid therapy for eosinophilic sinusitis

Abstract

The main objective of this study was to determine whether or not conservative treatment with steroids is effective for eosinophilic sinusitis. We studied 37 cases of eosinophilic sinusitis with a definitive diagnosis. Patients were divided into 2 groups: a conservative steroid therapy group (n=15) and an endoscopic sinus surgery (ESS) group (n=22). After retrospectively examining the degree of improvement in the nasal polyp score, nasal congestion score, and olfactory dysfunction in the conservative therapy group, these treatment results were compared between the two groups. In the conservative therapy group, nasal drops or steroid sprays were administered to all patients, and prednisolone (orally) was administered to 12 of the 15 patients (80%). In addition, 8 cases (53%) received inhaled corticosteroids for asthma in combination with exhalation through the nose. The pre- and posttreatment nasal polyp scores were compared in the conservative treatment group, and a significant improvement was noted on both the left and right sides (p < 0.001). There was also a significant improvement in the nasal congestion score (p < 0.001). Conservative steroid therapy alone for olfactory dysfunction led to complete remission in 6 of 15 cases (40%) and condition improvement in 8 cases (53%). There was a significant difference between the conservative therapy group and the ESS group in the pre-and posttreatment nasal polyp and nasal congestion scores but not in the degree of improvement in the sense of smell. This study showed that the combination of steroid nasal drops, nasal inhalation of steroid inhalers, and oral steroids can exert therapeutic effects on nasal congestion and olfactory dysfunction for eosinophilic sinusitis. However, a decrease in cortisol levels was observed in 5 of 9 cases (56%) receiving oral steroids as well as in 3 of 4 cases receiving long-term oral administration of Celestamine^®. When oral steroids, including Celestamine^®, are taken, careful treatment is recommended, and cortisol levels need to be monitored regularly.