167 / 236
Post-FESS long-term macrolide therapy for NP
FIGURE 1.
Study flowchart.
(3 months), respectively. On the 7th day after surgery,
all patients began maintenance therapy with mometasone
furoate nasal spray (Nasonex, MSD, Merck & Co., Inc.,
NJ, USA) 400
μ
g/day for a full 6 months, including group
3 (control no antibiotics) patients. The Ethics Committee
approved the final study protocol with all enrolled 66 pa-
tients signing consent forms.
Patients were carefully followed and seen at 6 weeks,
12 weeks, and 24 weeks after FESS (Fig. 1). Results of
treatment were based on evaluation of the following tests.
20-item SinoNasal Outcome Test (SNOT-20)
The 20-item SinoNasal Outcome Test (SNOT-20) is a ques-
tionnaire for evaluating the quality of life (QoL) in rhinos-
inusitis patients.
11
Visual analogue scale
The disease severity was assessed by the patients’ subjective
evaluation on the 10-cm visual analogue scale (VAS); 1 cm
on the scale reflected 1 point of the patient’s assessment;
0 to 3 points corresponded to mild disease, 3 to 7 points
corresponded to moderate disease, and 7 to 10 points cor-
responded to severe disease.
Olfactory test
The “Sniffin Sticks test,” extended version (Burghart
Messtechnik GmbH, Wedel, Germany) was used for each
patient.
12
Odor identification was assessed by means of 16
test tubes with different odors. The number of correct an-
swers was related to the degree of olfactory disturbance,
with 16 being the maximum score possible. A score from
0 to 6 reflects anosmia, a score from 7 to 12 is termed hy-
posmia, whereas a score ranging from 13 to 16 is normal.
Saccharin transit time test
This test measures the transit time for a saccharin particle to
pass from the anterior head of the inferior nasal turbinate to
the pharynx when the patient first experiences the sensation
of a sweet taste.
Nasal endoscopy
Endoscopy was performed with a rigid 2.7-mm endoscope
(Karl Storz, Tutlingen, Germany) without decongestion.
Semiquantitative scores were recorded for polyps, edema,
discharge, crusting, and scarring at baseline, 6 weeks,
12 weeks, and at the final assessment 24 weeks after FESS.
These results were evaluated using an endoscopic appear-
ance score (EAS).
4,13
Polyps were graded by size from 0
to 3 points; an absence of polyps was scored as 0, polyps
appearing only in middle meatus were scored as 1; polyps
extending beyond the middle meatus but not obstructing
the nose were scored a 2; and polyps completely obstruct-
ing the nose were scored a 3. Discharge was scored as
follows: 0
=
no discharge; 1
=
clear, thin discharge; and
International Forum of Allergy & Rhinology, Vol. 4, No. 7, July 2014
145