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Arch Otolaryngol Head Neck Surg. 2001 Feb;127(2):188-92.

Corticosteroid therapy during endoscopic sinus surgery in children: is there a need for a second look?

Author information

1
Department of Otolaryngology-Head and Neck Surgery, West Virginia University, PO Box 9200, Morgantown, WV 26506-9200, USA. hramadan@hsc.wvu.edu

Abstract

OBJECTIVE:

To determine whether intravenous administration of dexamethasone during endoscopic sinus surgery in children will decrease scarring and edema during a second-look procedure.

DESIGN:

Prospective, randomized, double-blind, placebo-controlled trial.

SETTING:

University medical center.

PATIENTS:

Forty-eight children undergoing endoscopic sinus surgery for chronic sinusitis.

INTERVENTION:

Twenty-four children received intravenous dexamethasone and 24 received placebo intraoperatively before the start of the procedure.

MAIN OUTCOME MEASURES:

The status of the ethmoid cavity, the status of the mucosa in the maxillary sinuses, and the patency of the maxillary sinus ostium during the second-look procedure performed 2 to 3 weeks after the primary procedure.

RESULTS:

Children who received intravenous dexamethasone had significantly less maxillary sinus mucosal edema, less ethmoid scarring, and a lower incidence of closure of the maxillary ostium (P = .02). During the second-look procedure, 62% of children in the noncorticosteroid group had abnormal findings vs 29% in the corticosteroid group. Patients with asthma, lower computed tomography scores, and no exposure to smoking had a significantly lower incidence of scarring with use of corticosteroids. Children older than 6 years benefited from intravenous corticosteroid therapy vs children 6 years and younger.

CONCLUSIONS:

Treatment with intravenous dexamethasone during endoscopic sinus surgery was safe and was helpful in reducing scarring and swelling noted during the second-look procedure. Use of corticosteroids was particularly helpful in children with asthma, lower computed tomography scores, and no exposure to smoking and in children older than 6 years.

PMID:
11177037
DOI:
10.1001/archotol.127.2.188
[Indexed for MEDLINE]

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