Muharrem DAĞLI, Engin DURSUN, Güleser SAYLAM, Emine AYDIN, Hülya ORTAPAMUK, Adil ERYILMAZ, Hakan KORKMAZ

Clinical and Rhinoscintigraphic Evaluation of Oral Macrolides in the Management of Sinonasal Polyposis

Aim: To document the efficacy of low-dose long-term oral macrolide treatment in the management of sinonasal polyposis. The study was designed prospectively in a group of patients with sinonasal polyposis and negative history of surgery. Materials and Methods: Ten patients were administered roxithromycin (RXM) 150 mg/day single oral dose for eight weeks. All patients underwent Tc-99m rhinoscintigraphic evaluation of mucociliary activity and endoscopic evaluation before and after the treatments. Response to treatment, in terms of rhinoscintigraphic and endoscopic improvement, was assessed. Results: Of the 10 patients, 7 were male and 3 female, with an average age of 46 years (27-74). Following treatment, mucociliary transport time was significantly reduced (P < 0.05) and the polyps were clinically shrunk (P < 0.05). Conclusions: It was determined that low-dose long-term oral macrolide treatment was effective in the management of sinonasal polyposis. Macrolides can be considered, as an alternative to or in conjunction with steroids, in the management of sinonasal polyposis.

Anahtar Kelimeler:

Sinonasal polyp, nasal polyp, nasal polyposis, macrolide, rhinoscintigraphy

Clinical and Rhinoscintigraphic Evaluation of Oral Macrolides in the Management of Sinonasal Polyposis

Keywords:

Sinonasal polyp, nasal polyp, nasal polyposis, macrolide, rhinoscintigraphy,

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Lund VJ, Mackay IS. Staging in rhinosinusitis. Rhinology 1993; 31: 183-4.
Bernstein JM. The molecular biology of nasal polyposis. Curr Allergy Asthma Rep 2001; 1: 262–7.
Hirschberg A, Jokuti A, Darvas Z, Almay K, Repassy G, Falus A. The pathogenesis of nasal polyposis by immunoglobulin E and interleukin-5 is completed by transforming growth factor-beta 1. Laryngoscope 2003; 113: 120-4.
Tos M, Mogensen C. Pathogenesis of nasal polyps. Rhinology 1977; 15: 87-95.
Bachert C, van Zele T, Gevaert P, De Schrijver L, Van Cauwenberge P. Superantigens and nasal polyps. Curr Allergy Asthma Rep 2003; 3: 523-31.
Smith D, Gerrard JM, White JG. Comparison of arachidonic acid metabolism in nasal polyps and eosinophils. Int Arch Allergy Appl Immunol 1987; 82: 83-8.
Passali D, Bernstein JM, Passali FM, Damiani V, Passali GC, Bellussi L. Treatment of recurrent chronic hyperplastic sinusitis with nasal polyposis. Arch Otolaryngol Head Neck Surg 2003; 129: 656-9.
Labro MT. Anti-inflammatory activity of macrolides: a new therapeutic potential? J Antimicrob Chemother 1998; 41(Suppl B): 37-46.
Garey KW, Alwani A, Danziger LH, Rubinstein I. Tissue reparative effects of macrolide antibiotics in chronic inflammatory sinopulmonary diseases. Chest 2003; 123: 261-5.
Nonaka M, Pawankar R, Saji F, Yagi T. Effect of roxithromycin on IL-8 synthesis and proliferation of nasal polyp fibroblasts. Acta Otolaryngol Suppl 1998; 539: 71-5.
Scaglione F, Rossoni G. Comparative anti-inflammatory effects of roxithromycin, azithromycin and clarithromycin. J Antimicrob Chemother 1998; 41(Suppl B): 47-50.
Lale AM, Mason JD, Jones NS. Mucociliary transport and its assessment: a review. Clin Otolaryngol 1998; 23: 388-96.
Di Giuda D, Galli J, Calcagni ML, Corina L, Paludetti G, Ottaviani F et al. Rhinoscintigraphy: a simple radioisotope technique to study the mucociliary system. Clin Nucl Med 2000; 25: 127-30.