Steroid Regimens Compared in Patients With Chronic Rhinosinusitis Without Nasal Polyps

Study authors conducted a prospective randomized trial to determine if there is a role for oral steroids in patients who have CRSsNP.

The following article features coverage from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNSF) Annual Meeting. Click here to read more of MPR‘s conference coverage.

In adults with chronic rhinosinusitis without nasal polyps (CRSsNP), the addition of oral steroids may lead to greater symptomatic improvement, according to a study presented at the AAO-HNS 2021 Annual Meeting, held October 3-6 in Los Angeles, California.

This prospective trial randomly assigned patients to receive amoxicillin clavulanate with intranasal corticosteroid spray (group 1); amoxicillin clavulanate, intranasal corticosteroid spray, and 6-day prednisone course (group2); or amoxicillin clavulanate, intranasal corticosteroid spray, and 20-day prednisone course (group 3).

Patients (N=33) who presented to a rhinology clinic with a history of chronic rhinosinusitis, Lund-Mackay scores of 6 or greater, and no evidence of polyps on a nasal endoscopy were enrolled and completed a Sinonasal Outcome Test-22 (SNOT-22) questionnaire. At week 4, the SNOT-22 questionnaire, computed tomography scans, and nasal endoscopy were repeated.

In the pretreatment analysis of the 3 groups, the SNOT-22, Lund-Mackay, and Lund-Kennedy scores were not found to be significantly different (P =.62; P =.72; P =.57, respectively). By week 4, SNOT-22 score averages decreased among all 3 groups, but the differences were not found to be statistically significant (P =.52). Significant Lund-Mackay score changes were observed in group 2 (mean decrease, 1.7 points; P =.07).

Findings also showed no significant differences in Lund-Mackay scores posttreatment (P =.98) or in the percentage of patients who required sinus surgery within a year of study enrollment (P =.82)

Based on these results, the study authors concluded that in adults with CRSsNP, “the addition of oral steroids had the greatest reported symptomatic improvement, with no appreciated difference between a 6-day and a 20-day steroid course.”


Perez HA, Miles E, Vuong C, Church C, Seiberling K. Comparison of steroid regimens in management of CRSsNP. Presented at: AAO-HNS 2021 Annual Meeting; October 3-6, 2021; Los Angeles, CA.