Control of Symptoms Clinical Trial
Official title:
Comparison of Topical Nasal Steroids in Postoperative Sinus Patients With Nasal Polyps
Topical nasal steroid sprays are the mainstream treatment for patients with nasal polyps. Polyps tend to recur after surgery and topical nasal steroid sprays are used as the primary medical management to prevent continued growth. More recently high dose topical nasal steroid sprays are used. It is thought that the higher dose will penetrate the sinus cavities at an increased dose and will allow for greater control of polyp growth. Safety studies have been performed which have shown no suppression of the pituitary axis with long term high dose topical steroid or changes in intraocular pressure. However, studies in efficacy are limited despite their widespread use. The objective of this study will be to compare the effectiveness of two topical nasal steroid sprays in patients with recurrent nasal polyps.
Recruitment plan- Patients with nasal polyps who have had sinus surgery at least 3 months
prior and documented nasal polyps by endoscopy will be prospectively recruited. This will be
a randomized blinded study. Patients will be randomized into two groups- group 1 will
received topical fluticasone and group 2 will receive topical dexamethasone spray to the
nasal cavity. The investigator will be blinded as to which group the subjects are placed in.
The medications will be given out from the inland compounding pharmacy located at 24747
Redlands Blvd, in Loma Linda.
Procedures
1. At the time of enrollment nasal endoscopy will be performed to confirm the diagnosis of
nasal polyps and to grade the size of the polyps. Polyp size will be graded by the
following scale: 0- no polyps, 1- polypoid mucosa, 2- polyps within sinus not occluding
ostium, 3- polyps occluding ostium filling nasal cavity
2. Subjects will be asked to fill out a SNOT 20 survey before the start of therapy.
3. Subjects will be randomized into 2 groups by the flip of a coin. The investigator will
be blinded to which group the subject is placed in. The pharmacist (Raylene Mote,
Inland compounding pharmacy) who compounds the medications will be the only one aware
of which medication was given.
4. Subjects will pick up their medication at the inland compounding pharmacy and will be
instructed to use the nasal spray- 2 sprays twice a day for 6 weeks.
5. After 6 weeks the subjects will return to the office for repeat nasal endoscopy and
will be asked to fill out a SNOT 20 survey.
6. Continued therapy of the nasal steroid spray will be at the discretion of the
physician. If subjects do not appear to be responding the nasal steroid spray the
medication will be altered as deemed medically necessary.
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