A comparative study of budesonide versus saline irrigations in postoperative care of patients with nasal polyposis

Objective: Endoscopic sinus surgery (ESS) is essential for effective topical drug delivery to paranasal sinuses. This study aimed to evaluate the effectiveness of budesonide nasal irrigations compared with saline irrigations during postoperative care of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: A total of 68 patients diagnosed with CRSwNP underwent ESS and were randomly enrolled by computer-generated block randomization method and divided into two study groups (A and B) of 34 participants each (normal saline [NS] + budesonide irrigation and NS irrigation alone, respectively). They were evaluated preoperatively and postoperatively at 6 weeks (T1), 10 weeks (T2), and 14 weeks (T3). Their assessment was done mainly with a 22-item sinonasal outcomes test (SNOT-22), and Lund–Mackay endoscopy (LME) scores. Results: The condition of the patients significantly improved in both intervention arms related to SNOT-22 and LME score at each postoperative visit (Group A: p<0.001; Group B: p<0.001). However, there was no significant difference between the two groups except at the last postoperative visit (SNOT-22: p=0.005; LME: p=0.009). In Group B, a higher recurrence of disease was reported (p=0.008). Conclusion: Steroid nasal irrigation is a good option in postoperative patients with CRSwNP and offers additional benefits over saline-alone irrigations. Comparative studies evaluating budesonide and saline nasal irrigations for patients with polyposis are deficient in the current literature. This study is one of the few comparative studies evaluating budesonide and saline nasal irrigations in post-ESS patients.