Short-course oral steroids as an adjunct therapy for chronic rhinosinusitis.

@article{Head2016ShortcourseOS,
  title={Short-course oral steroids as an adjunct therapy for chronic rhinosinusitis.},
  author={Karen Head and Lee Yee Chong and Claire Hopkins and Carl M. Philpott and Anne G M Schilder and Martin J. Burton},
  journal={The Cochrane database of systematic reviews},
  year={2016},
  volume={4},
  pages={
          CD011992
        }
}
BACKGROUND This review is one of a suite of six Cochrane reviews looking at the primary medical management options for patients with chronic rhinosinusitis.Chronic rhinosinusitis is a common condition involving inflammation of the lining of the nose and paranasal sinuses. It is characterised by nasal blockage and nasal discharge, facial pressure/pain and loss of sense of smell. The condition can occur with or without nasal polyps. Oral corticosteroids are used to control the inflammatory… 

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References

SHOWING 1-10 OF 80 REFERENCES

Short-course oral steroids alone for chronic rhinosinusitis.

The results at the end of treatment showed an improvement in patients receiving oral steroids compared to placebo, both when presented as a mean final value and as a change from baseline, which corresponds to a large effect size.

Intranasal steroids versus placebo or no intervention for chronic rhinosinusitis.

The effects of intranasal corticosteroids in people with chronic rhinosinusitis were assessed, disease-specific health-related quality of life (HRQL), patient-reported disease severity and the commonest adverse event - epistaxis.

Different types of intranasal steroids for chronic rhinosinusitis.

Low quality evidence was found relating to disease severity and nasal polyps size, with results from the high-dose and low-dose groups being similar and the primary adverse effect, epistaxis, was more common when higher doses were used.

Systemic and topical antibiotics for chronic rhinosinusitis.

The primary outcomes were disease-specific health-related quality of life (HRQL), patient-reported disease severity and the commonest adverse event - gastrointestinal disturbance and it is very uncertain if antibiotics were associated with an increase in gastrointestinal disturbances.

Saline irrigation for chronic rhinosinusitis.

The effects of saline irrigation in patients with chronic rhinosinusitis was evaluated and the evidence was assessed to be of low quality for the three months follow-up and very lowquality for the six months following-up.

Systemic corticosteroids for acute sinusitis.

Limited evidence suggests that oral corticosteroids in combination with antibiotics may be modestly beneficial for short-term relief of symptoms in acute sinusitis, with a number needed to treat to benefit of seven for resolution or symptom improvement.

Treatment of Chronic Rhinosinusitis With Nasal Polyposis With Oral Steroids Followed by Topical Steroids

Initial oral steroid therapy followed by topical steroids therapy seems to be more effective over 6 months than topical steroid therapy alone in decreasing polyp size and improving olfaction in patients referred for specialty care of CRS with at least moderate nasal polyposis.

Clinical efficacy of a short course of systemic steroids in nasal polyposis.

A short course of oral prednisolone showed good clinical efficacy in the treatment of nasal polyposis, however, polyps size grade 3 and/or positive nasal endoscopy predispose to a poorer treatment outcome.

Oral steroids and doxycycline: two different approaches to treat nasal polyps.

...