The Effect of Cryotherapy Spray with Fluticasone on Tissue Repair after Endoscopic Sinus Surgery in Patients with Nasal Polyposis: A Randomized Clinical Trial Study

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Otorhinolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Otorhinolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Resident, Department of Otorhinolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Recently, spray cryotherapy has been used in otorhinolaryngology surgeries. Therefore, due to limited studies in this field, this study aimed to evaluate the effect of spray cryotherapy on tissue repair after endoscopic sinus surgery in patients with nasal polyposis, and compare this method with fluticasone and normal saline spray.Methods: In this clinical trial study, 45 patients with nasal polyps were enrolled according to the inclusion criteria of the study. Then, the patients were randomly assigned into three equal groups. The first group was treated with spray cryotherapy, the second group was treated with fluticasone spray, and the third group received normal saline spray after the operation with four puffs for each group. It should be noted that fluticasone spray was maintained for two weeks after surgery for the three groups. Subsequently, the results of this study were evaluated using Sino-nasal Outcome Test (SNOT-22) questionnaire at intervals of one and three months after the surgical operation.Findings: The mean SNOT-22 score after the surgery significantly decreased in the three groups. There was a significant difference between the three groups concerning the SNOT-22 scores at intervals of one and three months after the surgery, as the SNOT-22 score in the cryotherapy group was lower than the other groups (P < 0.05).Conclusion: Using spray cryotherapy is a safe and effective method after endoscopic sinus surgery compared to the corticosteroid and normal saline spray.

Keywords

References

  1. Johansson L, Akerlund A, Holmberg K, Melen I, Stierna P, Bende M. Evaluation of methods for endoscopic staging of nasal polyposis. Acta Otolaryngol 2000; 120(1): 72-6.
  2. Lange B, Holst R, Thilsing T, Baelum J, Kjeldsen A. Quality of life and associated factors in persons with chronic rhinosinusitis in the general population: A prospective questionnaire and clinical cross-sectional study. Clin Otolaryngol 2013; 38(6): 474-80.
  3. Gohar MS, Niazi SA, Niazi SB. Functional endoscopic sinus surgery as a primary modality of treatment for primary and recurrent nasal polyposis. Pak J Med Sci 2017; 33(2): 380-2.
  4. Dumot JA, Vargo JJ, Zuccaro G, Falk GW, Frey L, Rice T. Results of cryospray ablation for esophageal high grade dysplasia (HGD) and intramucosal cancer (IMCA) in high risk non-surgical patients. Gastrointest Endosc 2008; 67(5): AB176.
  5. Bruley ME. A study of safety and performance requirements for cryosurgical devices. Springfield, VA: Department of Health and Human Services, Public Health Service, Food and Drug Administration, Bureau of Medical Devices; 1980. p. 200-7.
  6. Baust JG, Gage AA. Progress toward optimization of cryosurgery. Technol Cancer Res Treat 2004; 3(2): 95-101.
  7. Johnston MH, Eastone JA, Horwhat JD, Cartledge J, Mathews JS, Foggy JR. Cryoablation of Barrett's esophagus: A pilot study. Gastrointest Endosc 2005; 62(6): 842-8.
  8. Moore RF, Lile DJ, Abbas AE. Current status of spray cryotherapy for airway disease. J Thorac Dis 2017; 9(Suppl 2): S122-S129.
  9. Gocea A, Taulescu M, Trombitas V, Albu S. Effects of cryotherapy on the maxillary antrostomy patency in a rabbit model of chronic rhinosinusitis. Biomed Res Int 2013; 2013: 101534.
  10. Knott PD, Milstein CF, Hicks DM, Abelson TI, Byrd MC, Strome M. Vocal outcomes after laser resection of early-stage glottic cancer with adjuvant cryotherapy. Arch Otolaryngol Head Neck Surg 2006; 132(11): 1226-30.
  11. Rezaeian A. Outcome of spray cryotherapy plus functional endoscopic sinus surgery on management of healing in nasal polyposis. Am J Otolaryngol 2018; 39(1): 10-3.
  12. Chen JJ, Chen DL, Chen CJ. The Lund-Mackay score for adult head and neck computed tomography. Chinese J Radiol 201; 36(4): 203-8.
  13. Kennedy JL, Hubbard MA, Huyett P, Patrie JT, Borish L, Payne SC. Sino-nasal outcome test (SNOT-22):
  14. A predictor of postsurgical improvement in patients with chronic sinusitis. Ann Allergy Asthma Immunol 2013; 111(4): 246-51.
  15. Albu S, Trombitas V, Vlad D, Emanuelli E. The influence of spray cryotherapy on wound healing following endoscopic sinus surgery in chronic rhinosinusitis. Laryngoscope 2016; 126(1): 25-32.
  16. Browning R, Parrish S, Sarkar S, Turner JF. First report of a novel liquid nitrogen adjustable flow spray cryotherapy (SCT) device in the bronchoscopic treatment of disease of the central tracheo-bronchial airways. J Thorac Dis 2013; 5(3): E103-E106.
  17. Krimsky WS, Rodrigues MP, Malayaman N, Sarkar S. Spray cryotherapy for the treatment of glottic and subglottic stenosis. Laryngoscope 2010; 120(3): 473-7.
  18. Power NE, Silberstein JL, Tarin T, Au J, Thorner D, Ezell P, et al. Endoscopic spray cryotherapy for genitourinary malignancies: Safety and efficacy in a porcine model. Ther Adv Urol 2013; 5(3): 135-41.
  19. Bhora FY, Ayub A, Forleiter CM, Huang CY, Alshehri K, Rehmani S, et al. Treatment of benign tracheal stenosis using endoluminal spray cryotherapy. JAMA Otolaryngol Head Neck Surg 2016; 142(11): 1082-7.
Journal of Isfahan Medical School
Volume 38, Issue 586 - Serial Number 586
July and August 2020
Pages 563-568

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History

  • Receive Date: 02 April 2020
  • Revise Date: 29 April 2024
  • Accept Date: 06 April 2022

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