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The effects of nasal lavage with betamethasone cream post-endoscopic sinus surgery: clinical trial

Published online by Cambridge University Press:  12 September 2017

B Dawson ,
I Gutteridge ,
A Cervin  and
D Robinson
B Dawson*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Gold Coast University Hospital, Southport, Australia
I Gutteridge
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Gold Coast University Hospital, Southport, Australia
A Cervin
Affiliation:
Otolaryngology (Rhinology), Faculty of Medicine and Biomedical Sciences, School of Medicine, University of Queensland, Herston, Australia Department of ENT, Head and Neck Surgery, Royal Brisbane and Women's Hospital, Herston, Australia Otolaryngology, Centre for Clinical Research, University of Queensland, Herston, Australia Faculty of Medicine, Lund University, Sweden
D Robinson
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Gold Coast University Hospital, Southport, Australia
*
Address for correspondence: Dr Blake Dawson, Department of Otolaryngology, Head and Neck Surgery, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD 4215, Australia E-mail: blakedaw@gmail.com
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Abstract

Background:

Steroid nasal irrigation for chronic rhinosinusitis patients following endoscopic sinus surgery reduces symptom recurrence. There are minimal safety data to recommend this treatment. This study evaluated the safety of betamethasone nasal irrigation by measuring its impact on endogenous cortisol levels.

Methods:

Participants performed daily betamethasone nasal irrigation for six weeks. The impact on pre- and post-intervention serum and 24-hour urinary free cortisol was assessed. Efficacy was evaluated using the 22-item Sino-Nasal Outcome Test.

Results:

Thirty participants completed the study (16 females and 14 males; mean age = 53.9 ± 15.6 years). Serum cortisol levels were unchanged (p = 0.28). However, 24-hour urinary free cortisol levels decreased (47.5 vs 41.5 nmol per 24 hours; p = 0.025). Sino-Nasal Outcome Test scores improved (41.13 ± 21.94 vs 23.4 ± 18.17; p < 0.001). The minimal clinical important difference was reached in 63 per cent of participants.

Conclusion:

Daily betamethasone nasal irrigation is an efficacious treatment modality not associated with changes in morning serum cortisol levels. The changes in 24-hour urinary free cortisol levels are considered clinically negligible. Hence, continued use of betamethasone nasal irrigation remains a viable and safe treatment option for chronic rhinosinusitis patients following functional endoscopic sinus surgery.

Keywords

Chronic RhinosinusitisBetamethasoneNasal LavageCortisolEndoscopic Sinus Surgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 2 , February 2018 , pp. 143 - 149
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented as a poster at the Australian Society of Otolaryngology Head and Neck Surgery Annual Scientific Meeting, 6–8 March 2016, Sydney, Australia, and orally at the European Academy of Allergy and Clinical Immunology Congress, 12 June 2016, Vienna, Austria.

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