170 / 236
Varvyanskaya and Lopatin
TABLE 6.
Nasal resistance (Pa/cm
3
/second) as measured
by anterior rhinomanometry
Visits
Group 1
(antibiotics
24 weeks)
Group 2
(antibiotics
12 weeks)
Group 3
(control no
antibiotic)
Baseline
4.22
±
2.11
2.09
±
1.2
2.25
±
1.00
6 weeks
0.23
±
0.03
0.23
±
0.03
0.26
±
0.06
12 weeks
0.19
±
0.01
0.19
±
0.02
0.22
±
0.03
24 weeks
0.23
±
0.02
*
0.19
±
0.02
*
1.94
±
1.50
*Significant differences between study and control groups (
p
<
0.05).
TABLE 7.
Total nasal cavity volume (cm
3
) as measured
by acoustic rhinometry
Visits
Group 1
(antibiotics
24 weeks)
Group 2
(antibiotics
12 weeks)
Group 3
(control no
antibiotic)
Baseline
8.53
±
1.20
9.00
±
1.69
9.97
±
2.33
6 weeks
17.35
±
2.74
15.58
±
1.77
14.29
±
1.55
12 weeks
17.62
±
2.79
15.27
±
2.27
16.33
±
3.73
24 weeks
16.74
±
1.96
14.68
±
2.06
13.59
±
2.82
(antibiotics for 24 weeks) and group 2 (antibiotics for
12 weeks) was significantly lower (better breathing)
(0.23
±
0.02 and 0.19
±
0.02 Pa/cm
3
/second, respec-
tively) than in group 3 (control no antibiotics) (1.94
±
1.50 Pa/cm
3
/second) at endpoint (Tables 6 and 7).
CT scans
Before initiation of treatment, mean values for the Lund-
Mackay score in the first, second, and third patient groups
did not differ significantly, being 21.68
±
1.20, 21.84
±
1.66, and 21.2
±
1.57, respectively. The mean score of
paranasal sinus opacification on CT scans dramatically de-
creased (improved) in all 3 groups 6 months after FESS.
However, a significant difference was observed only be-
tween group 1 (antibiotics for 24 weeks) with a mean score
of 9.71
±
2.21, and group 3 (control no antibiotics) with a
mean score of 16.66
±
2.32 (
p
<
0.05). In group 2 (antibi-
otics for 12 weeks) the mean score was 12.62
±
4.15, but
this difference did not reach statistical significance (Fig. 3,
Table 8).
Nasal endoscopy
Patients on clarithromycin therapy in group 1 (antibiotics
for 24 weeks) and group 2 (antibiotics for 12 weeks)
showed better EAS at each visit when compared to patients
in group 3 who did not take antibiotics (Fig. 4, Table 9).
Twenty-four weeks after surgery mean EAS were: 1.52
±
0.87 in group 1 (antibiotics for 24 weeks) and 2.42
±
1.61
in group 2 (antibiotics for 12 weeks), and these results were
FIGURE 3.
Evaluation of CT scores, mean scores according to Lund-Mackay
scale (*
p
<
0.05). CT
=
computed tomography.
TABLE 8.
Lund-Mackay CT score evaluation (points)
Visits
Group 1
(antibiotics
24 weeks)
Group 2
(antibiotics
12 weeks)
Group 3
(control no
antibiotic)
Baseline
21.68
±
1.19
21.84
±
1.66
21.20
±
1.57
24 weeks
9.71
±
2.21
*
12.62
±
4.15
16.66
±
2.32
*Significant differences between study and control groups (
p
<
0.05).
CT
=
computed tomography.
FIGURE 4.
Evaluation of endoscopic findings in the nasal cavity calculated
according to Endoscopic Appearance Score (*
p
<
0.05).
significantly better than group 3 (control no antibiotics)
6.35
±
1.58 (
p
<
0.05) (Fig. 4, Table 9).
One of the most impressive cases demonstrating efficacy
of postoperative long-term macrolide therapy is presented
in Figure 5.
International Forum of Allergy & Rhinology, Vol. 4, No. 7, July 2014
148