The Effect of Preoperative Administration of Oral Steroids Versus Intranasal Steroid Spray on Intraoperative Bleeding of the Surgical Field During Endoscopic Sinus Surgery (ESS)
Department of Otorhinolaryngology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.
https://doi.org/10.21608/aimj.2025.446646
Abstract
Background: Nasal polyposis, a chronic inflammatory condition of the sinonasal mucosa, often requires Functional Endoscopic Sinus Surgery (FESS) when refractory to medical management. Preoperative corticosteroids have been proposed to improve surgical outcomes by reducing mucosal inflammation and intraoperative bleeding. Objective: To investigate and evaluate the effectiveness of intranasal steroid spray against oral steroid in reducing hemorrhage during Functional Endoscopic Sinus Surgery for nasal polyposis. Patients and Methods: This comparative prospective interventional research has been carried out on 60 cases diagnosed with nasal polyposis presenting to outpatient clinics of the Otorhinolaryngology Department at the Al-Azhar University hospitals (Al-Hussein & Bab El Shaeria) from July 2023 to April 2025. Patients were randomized into two groups: Group A received intranasal fluticasone spray (400 µg/day), while Group B received oral prednisolone (1 milligram per kilogram per day), both for seven days prior to surgery. Results: Group B (oral steroids) showed significantly lower blood loss (p=0.01) compared to Group A. Although both groups had comparable demographic data and symptom profiles, bronchial symptoms were significantly greater in Group A (p-value equal 0.008). Surgical field quality scores illustrated a statistically insignificant variance between the groups (p-value equal 0.88), but Group B demonstrated a trend toward better surgical conditions with fewer cases of moderate-to-severe bleeding. Conclusion: Oral corticosteroids are more effective in reducing intraoperative bleeding and improving the surgical field during FESS, supporting their use for enhanced surgical results in cases with nasal polyposis.
Abo ulwafa, W., Youssef, A., & Atia, M. (2025). The Effect of Preoperative Administration of Oral Steroids Versus Intranasal Steroid Spray on Intraoperative Bleeding of the Surgical Field During Endoscopic Sinus Surgery (ESS). Al-Azhar International Medical Journal, 2025(7), 119-123. doi: https://doi.org/10.21608/aimj.2025.446646
MLA
Wael Hassan Taha Abo ulwafa; Amr Hamdino Youssef; Mohamed Nazieh Ali Atia. "The Effect of Preoperative Administration of Oral Steroids Versus Intranasal Steroid Spray on Intraoperative Bleeding of the Surgical Field During Endoscopic Sinus Surgery (ESS)", Al-Azhar International Medical Journal, 2025, 7, 2025, 119-123. doi: https://doi.org/10.21608/aimj.2025.446646
HARVARD
Abo ulwafa, W., Youssef, A., Atia, M. (2025). 'The Effect of Preoperative Administration of Oral Steroids Versus Intranasal Steroid Spray on Intraoperative Bleeding of the Surgical Field During Endoscopic Sinus Surgery (ESS)', Al-Azhar International Medical Journal, 2025(7), pp. 119-123. doi: https://doi.org/10.21608/aimj.2025.446646
VANCOUVER
Abo ulwafa, W., Youssef, A., Atia, M. The Effect of Preoperative Administration of Oral Steroids Versus Intranasal Steroid Spray on Intraoperative Bleeding of the Surgical Field During Endoscopic Sinus Surgery (ESS). Al-Azhar International Medical Journal, 2025; 2025(7): 119-123. doi: https://doi.org/10.21608/aimj.2025.446646
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