Effect of topical furosemide on sinonasal polyposis relapse after endoscopic sinus surgery

Souvagini Acharya; Alka Kapil; Kamalini Bepari; Sandrendu Rajan; Prachi Mohapatra; Ashima Mishra; Aishwarya Aparajita

doi:10.18203/issn.2454-5929.ijohns20205628

Authors

Souvagini Acharya Department of Otorhinolaryngology and Head Neck Surgery, VSSIMSAR, Burla, Odisha, India
Alka Kapil Department of Otorhinolaryngology and Head Neck Surgery, VSSIMSAR, Burla, Odisha, India
Kamalini Bepari Department of Otorhinolaryngology and Head Neck Surgery, VSSIMSAR, Burla, Odisha, India
Sandrendu Rajan Department of Otorhinolaryngology and Head Neck Surgery, VSSIMSAR, Burla, Odisha, India
Prachi Mohapatra Department of Internal Medicine, IMS, BHU, Varanasi, Uttar Pradesh
Ashima Mishra Department of Internal Medicine, VSSIMSAR, Burla, Odisha, India
Aishwarya Aparajita Department of Otorhinolaryngology and Head Neck Surgery, VSSIMSAR, Burla, Odisha, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20205628

Keywords:

Topical furosemide, Sinonasal polyposis, Relapse, Endoscopic sinus surgery, VAS, Meltzer endoscopic grading

Abstract

Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) relapse is commonly seen during follow up period after endoscopic sinus surgery. Some studies claim the credibility of topical furosemide in preventing the polyposis recurrence after surgery. This randomised control trial was done to check the effectiveness of topical furosemide on sinonasal polyposis relapse after the endoscopic sinus surgery.

Methods: In the current study, 44 patients, attending ENT department, VSSIMSAR, for follow up after endoscopic sinus surgery, were evaluated clinically and endoscopically to demonstrate the prevalence and severity of polyposis relapse using Visual analogue scale (VAS) and meltzer endoscopic grading, before initiating the intervention. Patients were then randomised in two groups- one receiving topical furosemide nebulization and other intranasal normal saline spray, respectively. All patients were evaluated again at 1st, 2nd, 4th and 6th month follow-ups by VAS and MEG, setting statistical significance at p<0.05.

Results: The MEG was grade 0 in 77% (17) patients of furosemide group and 32% (7) of normal saline group (p=0.0147). Statistically significant improvement was also observed in VAS for nasal symptoms in former group (p=0.028) than latter. The rate of relapse was less (23.81%) in furosemide group as compared to normal saline group (65%) but result not statistically significant at p<0.05.

Conclusions: Topical furosemide can be used as a valid therapeutic approach for reducing the severity of sinonasal polyposis relapse after endoscopic sinus surgery with no known side effects of furosemide when administered topically.

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