Effect of Increasing Preoperative Steroid Therapy Duration on Surgical Field Visibility in Patients with Chronic Rhinosinusitis with Nasal Polyps

Background: Chronic rhinosinusitis (CRS) can be described as inflammation of the nasal cavity and one or more of the paranasal sinuses, and it is thought to afflict around 15% of adults. The prevalence of CRS ranges from 1% to 4%, however other studies have found rates as high as 32%.
Objective: The current work aimed to compare the effect of short duration (5 days) and long duration (15 days) of preoperative steroid therapy on surgical field visibility, bleeding during surgery and operative time in patients with Chronic rhinosinusitis with nasal polyps (CRSwNP) undergoing functional endoscopic sinus surgery (FESS).
Patients and methods: This randomized controlled trial study was conducted at the Department of Otorhinolaryngology, Ghamra Military Hospital and Kobri Elkobba Military Medical Complex. This study was carried on 74 patients with chronic rhinosinusitis with nasal polyps (CRSwNP) undergoing FESS, divided into two groups: group 1 (37 patients received 10 mg prednisone daily for 5 days before surgery) and group 2 (37 patients received 10 mg prednisone daily for 15 days before surgery). Results: There were significant differences regarding operative time, blood loss, and surgical field visibility. Group 2 had shorter operating times, better surgical field visibility scores, and lesser blood loss during the operation than group 1.
Conclusion: It could be concluded that the mean operating time, the mean amount of blood loss, and the mean Boezaart score are shorter in patients with CRSwNP who received a longer duration of steroid therapy when compared to patients with CRSwNP who received a shorter duration of steroid therapy. Also, 10 mg prednisone for 15 days can reduce blood loss during FESS more efficiently than treatment with 10 mg prednisone for 5 days.