Evaluation of long-termoutcomes of chronic rhinosinusitis patientswith nasal polyps in our clinic

Subject: Evaluation of Long-TermOutcomes of Chronic Rhinosinusitis Patientswith Nasal Polyps in Our Clinic Objective: To evaluate the effectiveness of long-term antibiotic therapy used in the treatment of chronic rhinosinusitis with nasal polyps and to determine its effect on quality of life. Method: 72 adult patients diagnosed with NPCRS were included in the study. The patients were evaluated three times during the six-month follow-up period and the results were compared statistically. Initial and final evaluations were made with ENT examination including nasal endoscopy, SNOT-22, SF-36 questionnaires, Lund–Mackey score, and Kennedy-osteit score. Prick test was applied during the first visit. The patients were divided into three groups according to the treatments they received; only INS (group 1), INS and macrolide group antibiotics (group 2), INS and doxycycline group antibiotics (group 3). Antibiotics were used as low dose for eight weeks. All patients additionally applied nasal irrigation. Intrapolyp injection of triamcinolone was administered to patients who did not benefit from the treatment. Tissue samples of patients who were operated during follow-up were evaluated for eosinophilia. At the first visit, osteitis was observed in 35 (48.6%) of the patients. Results: Of the 72 patients who participated in our study; 43 (59.7%) were male and 29 (40.3%) were female. Average age; It was found to be 47.67 ±16.26 in male gender, 50.21 ±15 in female gender, and 48.69± 15.71 in all patients. In our study, skin prick test was performed on 68 of 72 patients and it was found to be positive in 32 (47.1%). Samter's triad was detected in 8 patients (11.1%) in the entire patient group. While a decrease in polyp stages was detected in Group 3 (p<0.05), no significant change was observed in Kennedy-osteit scores (p>0.05). A significant decrease in Lund-Mackey scores was found in group 2 and group 3 (p=0.045, p=0.049). There was no significant change in Lund-Mackey scores in Group 1 (p>0.05). In group 1 (p=0.016) and group 2 (p=0.005), Kennedy-osteit scores increased over time. There was no difference between the treatment groups in terms of changes in SNOT-22 score and SF-36 scores. There was no significant change in polyp stages, SNOT-22, Lund-Mackey and Kennedy-osteit scores in patients who received triamcinolone injection compared to those who did not. Conclusion: In our study, it was determined that clinical and radiological improvement was better with low-dose doxycycline treatment in NPCR patients than in other groups. We think that studies in which groups with a larger number of patients will be followed for a longer period of time in chronic rhinosinusitis with nasal polyps will contribute to the regulation of the medical treatment algorithm. Keywords: nasal polyp, doxycycline, macrolide, osteitis, Lund-Mackey