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. 2015 Sep;67(3):299-307.
doi: 10.1007/s12070-014-0766-7. Epub 2014 Sep 9.

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

Ettore Cassandro  1 , Giuseppe Chiarella  2 , Matteo Cavaliere  3 , Giulio Sequino  1 , Claudia Cassandro  1 , Sampath Chandra Prasad  4 , Alfonso Scarpa  1 , Maurizio Iemma  3
Affiliations

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

Ettore Cassandro et al. Indian J Otolaryngol Head Neck Surg. 2015 Sep.

Abstract

Chronic rhinosinusitis (CRS) is a common condition and affects the quality of life of approximately 16 % of adults in US and 10.9 % in Europe. Hyaluronan (HA) is a nonsulphate glycosaminoglycan found in the extracellular matrix of connective tissues, and plays an important role in the healing process and repair of mucosal surfaces. We aim to evaluate the effect of HA on nasal symptoms and endoscopic appearance in patients with CRS and nasal polyps (NP) who have not undergone sinus surgery. Eighty patients older than 18 years old were randomized to receive either open-label nebulized saline solution (NS) or intranasal corticosteroid spray (ICS) 200 µg bid or nebulized sodium hyaluronate (NHA, YABRO(®)) or both ICS and NHA. Results were collected at 1 month, 3 months and 3 months after treatment. Significant improvements in nasal symptoms scores, endoscopic appearance scores, radiologic scores, rhinomanometry and saccharine clearance test were observed in the NHA, ICS and ICS + NHA groups after 1 month and 3 months of treatment compared with baseline (all p ≤ 0.005). The use of oral steroids was significantly reduced after 3 months of therapy in the same groups versus baseline (all p < 0.05). The incidence of adverse events at 3 months was similar between the 4 groups (all p > 0.05). Throat irritation, nasal burning and drug-related epistaxis were not reported in the group NHA. HA, as a nebulized nasal douche preparation, improved nasal symptoms and endoscopic appearances in patients with CRS and NP who have not undergone sinus surgery.

Keywords: Chronic rhinosinusitis; Glycoaminoglycans; Hyaluronan; Hyaluronic; Nasal polyposis; Randomized; Rhinomanometry; YABRO®.

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Figures

Fig. 1
Fig. 1
Mean total nasal symptoms scores during the overall treatment and follow-up periods of the trial
Fig. 2
Fig. 2
Mean endoscopic appearance scores during the overall treatment and follow-up periods of the trial
Fig. 3
Fig. 3
Mean radiological scores during the overall treatment and follow-up periods of the trial
Fig. 4
Fig. 4
Mean rhinomanometry scores during the overall treatment period and at the 3-month follow-up period
Fig. 5
Fig. 5
Mean times for the saccharine clearance tests before, during and after the treatment period
Fig. 6
Fig. 6
CT scans of a patient in the NHA treatment group with chronic polypoid pansinusitis (about 30 years) showing obstruction and erosion of ostia: a CT scan at the baseline; b CT scan at 3 months after the end of the therapy. Marked reduction of the mucosa hypertrophy is visible
See this image and copyright information in PMC

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