Impact of Preoperative Systemic Corticosteroids on the Histology and Diagnosis of Eosinophilic Chronic Rhinosinusitis [25] |
Akiyama 2019 |
Case series |
44 |
Preoperative oral prednisolone (0.3 mg/kg as a guide). |
Not mentioned. |
Oral prednisolone did not appear to markedly affect the tissue eosinophil count. |
Low |
Prospective evaluation of oral corticosteroid as a predictor of postoperative olfactory recovery after functional endoscopic surgery for nasal polyposis [26] |
Rives 2019 |
Prospective |
119 |
Oral prednisolone 1 mg/kg/day for 5 days preoperatively. |
Not mentioned. |
Olfactory recovery greater than 50% after a course of OCS therapy may be a predictor of better subjective postoperative recovery. |
Low |
Differential effects of postoperative oral corticosteroid on eosinophilic vs. non-eosinophilic CRSwNP subtypes [27] |
Shen 2019 |
Randomized controlled trial |
100 |
Oral prednisolone (30 mg/day) for 2 weeks after surgery. |
No severe side effects. |
The subjective parameters, including self-rated nasal health, decreased in both groups over time, but demonstrated no statistically significant differences between the corticosteroid and placebo groups. |
Moderate |
Effect of steroids for nasal polyposis surgery: A placebo-controlled, randomized, double-blind study [28] |
Ecevit 2015 |
Randomized controlled trial |
22 |
Six pills of 10 mg prednisolone and 90 mg lactose for 7 days, reduced to one pill taken every other day preoperatively. |
Not mentioned. |
Preoperative administration of systemic corticosteroids improves the perioperative visibility by reducing blood loss and shortens the operation time. |
Moderate |
Impact of perioperative systemic steroids on surgical outcomes in patients with chronic rhinosinusitis with polyposis: evaluation with the novel Perioperative Sinus Endoscopy (POSE) scoring system [29] |
Wright 2007 |
Randomized controlled trial |
26 |
30 mg of prednisone for 5 days preoperatively and 9 days postoperatively. |
Not mentioned. |
Pretreatment with systemic corticosteroids appears to confer the advantages of facilitating surgery and results in endoscopically healthier sinus cavities in the short term. |
Moderate |
Oral Corticosteroids Following Endoscopic Sinus Surgery for Chronic Rhinosinusitis Without Nasal Polyposis: A Randomized Clinical Trial [30] |
Chang 2021 |
Randomized controlled trial |
72 |
12-day postoperative taper of oral prednisone: 30 mg, 4 days; 20 mg, 4 days; and 10 mg 4 days. |
Not mentioned. |
Oral prednisone following endoscopic sinus surgery conferred no additional benefit over placebo. These results suggest that the risks of oral corticosteroids may outweigh the benefits. |
Moderate |
Lack of additive benefit of oral steroids on short-term postoperative outcomes in nasal polyposis [31] |
Arancibia 2020 |
Randomized controlled trial |
70 |
Postoperative 30 mg of oral prednisone for 1 week, 20 mg for 1 week, 10 mg for 1 week, and finally 5 mg for 1 week. |
Not mentioned. |
Postoperative OCS as an add-on treatment for CRSwNP patients does not improve sinonasal and QoL outcomes; thus, they should not be routinely recommended. |
Moderate |