• Brian W Rotenberg, Irene Zhang, Ian Arra, and Keith B Payton.
• Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. brian.rotenberg@sjhc.london.on.ca
• Laryngoscope. 2011 Dec 1; 121 (12): 2702-5.

Objectives/HypothesisEvidence is lacking to guide the postoperative management of Samter's triad patients with chronic rhinosinusitis with polyposis (CRSwP) undergoing endoscopic sinus surgery (ESS). The purpose of this study was to compare three different standardized medication regimens prescribed to these patients after ESS.Study DesignThree-arm, randomized, double-blinded, controlled trial.MethodsPatients with Samter's triad undergoing ESS were postoperatively randomized into three medication regimens, those being saline irrigation alone (control group A), saline irrigation plus separate budesonide nasal spray (group B), and saline irrigation mixed with budesonide nasal spray (group C). Outcome measures were Sino-Nasal Outcome Test scores, Lund-Mackay computed tomography scores, and Lund-Kennedy endoscopic scores taken at preoperative baseline, and then at 6 months and 1 year postoperatively. Side effect profiles were also measured (adrenocorticotropic hormone blood level ranges and intraocular pressure at the same interval points). Analysis of variance and χ(2) analyses were conducted using a Bonferroni correction method and routine descriptive statistics. Inter- and intragroup comparisons were made.ResultsSixty subjects were recruited. All groups were equivalent at baseline in all outcomes. All intragroup analyses showed statistically and clinically significant improvement in disease status as compared to baseline (P < .0167), with a sustained but lessened improvement at 1 year. However, no statistically or clinically significant differences were observed between groups at any time point (P > .05). There was no treatment effect noted.ConclusionsIn this study, nasal steroids did not confer any additional benefit over saline alone as post-ESS care for the Samter's triad CRSwP patient population.Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

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