Oral Corticosteroid Regimens in the Management of Chronic Rhinosinusitis

Ear Nose Throat J. 2022 Feb;101(2):123-130. doi: 10.1177/0145561319876906. Epub 2020 Jul 28.

Abstract

Background: Oral corticosteroids are often used in the medical management of chronic rhinosinusitis (CRS) with and without polyps. The purpose of our study is to review the literature for studies reporting the dosage of oral corticosteroids as part of the appropriate medical management prior to, immediately before, and after surgical intervention.

Methods: We reviewed the literature for oral corticosteroid regimens given to patients with CRS from March 2012 to September 2018. Studies that did not disclose the exact doses of the regimen were excluded from our analysis.

Results: Our search resulted in 7 articles with 4 studies of Level of Evidence (LOE) 1b, 2 studies with LOE III, and 1 study with LOE IV. The daily doses varied from 15 mg to 1 mg/kg, and with total doses ranging from 150 to 352 mg. In addition, several studies gave the same regimen to both subtypes of CRS. There was no mention of side effects in most of the studies.

Conclusion: There is a wide variation in the steroid doses given to patients with CRS and prospective or randomized controlled trials are needed to provide better improved evidence.

Keywords: CRS; CRSsNP; CRSwNP; chronic rhinosinusitis; nasal polyposis; oral steroids; steroids.

MeSH terms

  • Administration, Oral
  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Chemotherapy, Adjuvant
  • Chronic Disease
  • Drug Administration Schedule
  • Humans
  • Rhinitis / drug therapy*
  • Rhinitis / surgery
  • Sinusitis / drug therapy*
  • Sinusitis / surgery

Substances

  • Adrenal Cortex Hormones