The Role of Budesonide Intrapolyp Injection in CRSwNP
CRS, Polyp, Nasal
About this trial
This is an interventional treatment trial for CRS focused on measuring budesonide, CRSwNP, chronic Rhinosinusitis, Nasal polyps, Intrapolyp injection
Eligibility Criteria
Inclusion Criteria:
- All patients with type 2 CRSwNP -indicated by elevated serum IgE & high absolute Eosinophilia- with nasal polyps whose
- ages between 18 and 60 years old
- who don't have any contraindications of systemic steroids such as glaucoma, peptic ulcer, acute psychosis, chronic infections, severe osteoporosis, severe hypertension, uncontrolled diabetes mellitus, history of thromboembolic events
Exclusion Criteria:
- cystic fibrosis
- ciliary dyskinesia,
- antrochoanal polyp
- fungal sinusitis,
- unilateral nasal polyps, a
- patients who took systemic steroids in the last 6 months before our study were excluded.
Sites / Locations
- Kafrelsheikh University hospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
Active Comparator
Budesonide Intrapolyp injection
budesonide wash
Oral steroid
patients are to receive Endoscopic Intrapolyp steroid injection weekly for 5 weeks, using the following technique, where 2 nasal packs soaked in xylometazoline hydrochloride 0.1% " Otrivin adult nasal drops" applied one pack in each nostril for 5 minutes before injection, then using the 0° nasal endoscopy patients receive intrapolyp budesonide injection by 0.5 mg/ml budesonide respules "commercially available as Pulmicort ampules" 1 ml for each nostril using 1 cc 28 gauge needle sterile syringe, where injections carefully distributed amongst visible polyps avoiding visible vessels, No local anesthesia will be used before injections, patients come back to the clinic weekly to complete a series of 5 injections.
patients will be instructed to perform budesonide nasal wash, through a 250 ml squeeze bottle filled with saline, 0.5 mg/ml budesonide "Pulmicort ampule" added to the solution and half the amount used for each nostril, patients gurgle with antiseptic solution to minimize the risk of oral candidiasis, patients carry out the wash twice daily for one month duration
patients receive oral prednisolone 1 mg/kg/d tapering it by 5 mg/day for 2 weeks, patients will be prescribed omeprazole 20mg protective against gastrointestinal effects of steroid