The role of topical corticosteroids after functional endoscopic sinus surgery for chronic sinusitis and/or nasal polyps

Introduction. The objective was determination of the influence of Fluticasone propionate nasal spray on the recurrence rate of chronic sinusitis and/or nasal polyps after functional endoscopic sinus surgery (FESS) using a randomized double-blind placebo-controlled trial. Methods. From 1994 to 1997, 162 patients were included in this trial after FESS for chronic sinusitis and/or nasal polyps. Postoperatively they were treated for 1 year with study medication (double-blind). Study medication contained Fluticasone propionate nasal spray 400 μg bid, or Fluticasone propionate nasal spray 800 μg bid, or placebo bid. Symptoms (using visual analogue scales) and nasendoscopy findings were scored preoperatively and postoperatively for 1 year. Results. No reduction of the recurrence rate of chronic sinusitis or nasal polyps was found in the patient-groups using Fluticasone propionate nasal spray. No reduction was found when separate groups were analysed (such as nasal polyps, chronic sinusitis, allergy, no history of FESS or use of topical corticosteroids, or high score at FESS). Conclusion. In this trial no positive influence of Fluticasone propionate nasal spray could be found on the recurrence rate of chronic sinusitis and/or nasal polyps.