Dergiler / The Turkish Journal of Ear Nose and Throat / 2002 / Cilt: 9 Sayı: 5
Nazal polipozisli hastalarda kombine antihistaminik, steroid ve makrolid tedavisinin etkinliği: On sonuçlar
- Sayfa
- 352–357
- DOI
- —
Özet
Amaç: Önceden medikal veya cerrahi tedavi görmemifliki taraflı nasal polipozisli olgularda kombine medikaltedavinin etkinliğini değerlendirdik. Hastalar ve Yöntemler: Çalıflmaya iki taraflı nasal polipozisli ve önceden ameliyat geçirmeyen 25 hasta alındı. Hastalaramedikal tedavi olarak oral antihistaminik günde tek doz,üç hafta , topikal nazal steroidli sprey günde iki kez, altıay ve tek doz intramusküler sistemik steroid uygulandı.Üç haftalık tedaviye yanıt vermeyen hastalara makrolidgrubu klaritromisin antibiyotik verildi. Hastaların tedaviye yanıtları subjektif olarak semptomlara yönelik anketformu ile, objektif sonuçlar ise bilgisayarlı tomografi bulguları ve endoskopik muayene skorlarına göre değerlendirildi. Tedaviden sonra üçüncü hafta ve altıncı aydaki son u ç l a r, tedavi öncesi bulgularla karflılafltırıldı.Bu l g u l a r : Üçüncü hafta ve altıncı ayın sonunda hastaların flikayetlerinde sırasıyla %85.5 ve %79 oranlarında iyileflme görüldü p
Abstract
Objectives: We evaluated the efficacy of combined med ical treatment in cases with bilateral nasal polyposis vvithout a history of any surgical or medical treatment.Patients and Methods: Twenty-five patients 19 males, 6 females; mean age 45 years; range 30 to 60 years who had not received any treatment for bilateral nasal polyposis were included. Treatment was comprised of an oral anti-histaminic agent single dose daily for 3 weeks , and a topical steroid as a nasal spray, twice daily for 6 months and a single dose of intramuscular systemic steroid. Patients who did not respond to this therapy at the end of three weeks were administered a macrolide antibiotic clarithromycin . The results were evaluated before treatment, and three weeks and six months after treatment with the use of a patient questionnaire, com- puted tomography and endoscopic examination findings.Results: The patients’ complaints improved by 85.5% and 79% at the end of three weeks and six months, respectively p<0.005 . Radiologic improvement was found to be 64% at the end of six months p<0.005 .The overall decrease in the size of the polyps was significant p<0.005 . No treatment-associated complications were encountered.Conclusion: Significant improvement achieved favors the use of combined medical treatment before surgery in selected patients with nasal polyposis.