Effect of systemic steroids on humming nasal nitric oxide in chronic rhinosinusitis with nasal polyposis

Sriram Vaidyanathan, Peter Williamson, Kathleen Anderson, Brian Lipworth

    Research output: Contribution to journalArticle

    11 Citations (Scopus)

    Abstract

    Background: Increased nasal nitric oxide (NO) is a marker for paranasal sinus ostial patency. However, there are no data evaluating the effect of systemic steroids on humming nasal NO in chronic rhinosinusitis with nasal polyposis (CRSNP).

    Objectives: To assess whether 2 weeks of oral steroids in CRSNP increases humming nasal NO, whether humming is a more sensitive indicator of this increase than other methods of measuring NO, and whether it correlates with improvements in clinical parameters for sinonasal disease.

    Methods: Adults with CRSNP (grade 2 and above) were treated with oral prednisolone, 25 mg/d for 2 weeks. Nasal NO was measured by aspiration, exhalation at 0.2 L.s(-1), and humming methods. Peak nasal inspiratory flow, Sinonasal Outcomes Test 20 score, symptoms, olfaction, and polyp grade were also measured before and after treatment.

    Results: Twelve patients (mean age, 49 years) completed the treatment. The differences in nasal NO before and after steroid treatment were significantly less pronounced as measured by geometric mean-fold ratio with aspiration (1.5; 95% confidence interval [CI], 1.1 to 1.9; P = .009) and exhalation (2.1; 95% CI, 1.2 to 3.9; P = .02) compared with the humming technique (4.9; 95% CI, 2.2 to 10.7; P = .001). The standardized response means for the methods of NO estimation were 0.97 for aspiration, 1.05 for exhalation, and 1.61 for humming.

    Conclusions: This study demonstrates that humming nasal NO increases after 2 weeks of oral steroid therapy for CRSNP. Humming NO is more sensitive than aspiration and exhalation and is associated with improvements in symptoms, polyp size, and quality of life. Humming NO may fill the niche for a noninvasive marker of sinus ostial patency. Ann Allergy Asthma Immunol. 2010;105:412-417.

    Original languageEnglish
    Pages (from-to)412-417
    Number of pages6
    JournalAnnals of Allergy, Asthma & Immunology
    Volume105
    Issue number6
    DOIs
    Publication statusPublished - Dec 2010

    Keywords

    • Allergic rhinitis

    Cite this

    Vaidyanathan, Sriram ; Williamson, Peter ; Anderson, Kathleen ; Lipworth, Brian. / Effect of systemic steroids on humming nasal nitric oxide in chronic rhinosinusitis with nasal polyposis. In: Annals of Allergy, Asthma & Immunology. 2010 ; Vol. 105, No. 6. pp. 412-417.
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    title = "Effect of systemic steroids on humming nasal nitric oxide in chronic rhinosinusitis with nasal polyposis",
    abstract = "Background: Increased nasal nitric oxide (NO) is a marker for paranasal sinus ostial patency. However, there are no data evaluating the effect of systemic steroids on humming nasal NO in chronic rhinosinusitis with nasal polyposis (CRSNP).Objectives: To assess whether 2 weeks of oral steroids in CRSNP increases humming nasal NO, whether humming is a more sensitive indicator of this increase than other methods of measuring NO, and whether it correlates with improvements in clinical parameters for sinonasal disease.Methods: Adults with CRSNP (grade 2 and above) were treated with oral prednisolone, 25 mg/d for 2 weeks. Nasal NO was measured by aspiration, exhalation at 0.2 L.s(-1), and humming methods. Peak nasal inspiratory flow, Sinonasal Outcomes Test 20 score, symptoms, olfaction, and polyp grade were also measured before and after treatment.Results: Twelve patients (mean age, 49 years) completed the treatment. The differences in nasal NO before and after steroid treatment were significantly less pronounced as measured by geometric mean-fold ratio with aspiration (1.5; 95{\%} confidence interval [CI], 1.1 to 1.9; P = .009) and exhalation (2.1; 95{\%} CI, 1.2 to 3.9; P = .02) compared with the humming technique (4.9; 95{\%} CI, 2.2 to 10.7; P = .001). The standardized response means for the methods of NO estimation were 0.97 for aspiration, 1.05 for exhalation, and 1.61 for humming.Conclusions: This study demonstrates that humming nasal NO increases after 2 weeks of oral steroid therapy for CRSNP. Humming NO is more sensitive than aspiration and exhalation and is associated with improvements in symptoms, polyp size, and quality of life. Humming NO may fill the niche for a noninvasive marker of sinus ostial patency. Ann Allergy Asthma Immunol. 2010;105:412-417.",
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    Effect of systemic steroids on humming nasal nitric oxide in chronic rhinosinusitis with nasal polyposis. / Vaidyanathan, Sriram; Williamson, Peter; Anderson, Kathleen; Lipworth, Brian.

    In: Annals of Allergy, Asthma & Immunology, Vol. 105, No. 6, 12.2010, p. 412-417.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Effect of systemic steroids on humming nasal nitric oxide in chronic rhinosinusitis with nasal polyposis

    AU - Vaidyanathan, Sriram

    AU - Williamson, Peter

    AU - Anderson, Kathleen

    AU - Lipworth, Brian

    PY - 2010/12

    Y1 - 2010/12

    N2 - Background: Increased nasal nitric oxide (NO) is a marker for paranasal sinus ostial patency. However, there are no data evaluating the effect of systemic steroids on humming nasal NO in chronic rhinosinusitis with nasal polyposis (CRSNP).Objectives: To assess whether 2 weeks of oral steroids in CRSNP increases humming nasal NO, whether humming is a more sensitive indicator of this increase than other methods of measuring NO, and whether it correlates with improvements in clinical parameters for sinonasal disease.Methods: Adults with CRSNP (grade 2 and above) were treated with oral prednisolone, 25 mg/d for 2 weeks. Nasal NO was measured by aspiration, exhalation at 0.2 L.s(-1), and humming methods. Peak nasal inspiratory flow, Sinonasal Outcomes Test 20 score, symptoms, olfaction, and polyp grade were also measured before and after treatment.Results: Twelve patients (mean age, 49 years) completed the treatment. The differences in nasal NO before and after steroid treatment were significantly less pronounced as measured by geometric mean-fold ratio with aspiration (1.5; 95% confidence interval [CI], 1.1 to 1.9; P = .009) and exhalation (2.1; 95% CI, 1.2 to 3.9; P = .02) compared with the humming technique (4.9; 95% CI, 2.2 to 10.7; P = .001). The standardized response means for the methods of NO estimation were 0.97 for aspiration, 1.05 for exhalation, and 1.61 for humming.Conclusions: This study demonstrates that humming nasal NO increases after 2 weeks of oral steroid therapy for CRSNP. Humming NO is more sensitive than aspiration and exhalation and is associated with improvements in symptoms, polyp size, and quality of life. Humming NO may fill the niche for a noninvasive marker of sinus ostial patency. Ann Allergy Asthma Immunol. 2010;105:412-417.

    AB - Background: Increased nasal nitric oxide (NO) is a marker for paranasal sinus ostial patency. However, there are no data evaluating the effect of systemic steroids on humming nasal NO in chronic rhinosinusitis with nasal polyposis (CRSNP).Objectives: To assess whether 2 weeks of oral steroids in CRSNP increases humming nasal NO, whether humming is a more sensitive indicator of this increase than other methods of measuring NO, and whether it correlates with improvements in clinical parameters for sinonasal disease.Methods: Adults with CRSNP (grade 2 and above) were treated with oral prednisolone, 25 mg/d for 2 weeks. Nasal NO was measured by aspiration, exhalation at 0.2 L.s(-1), and humming methods. Peak nasal inspiratory flow, Sinonasal Outcomes Test 20 score, symptoms, olfaction, and polyp grade were also measured before and after treatment.Results: Twelve patients (mean age, 49 years) completed the treatment. The differences in nasal NO before and after steroid treatment were significantly less pronounced as measured by geometric mean-fold ratio with aspiration (1.5; 95% confidence interval [CI], 1.1 to 1.9; P = .009) and exhalation (2.1; 95% CI, 1.2 to 3.9; P = .02) compared with the humming technique (4.9; 95% CI, 2.2 to 10.7; P = .001). The standardized response means for the methods of NO estimation were 0.97 for aspiration, 1.05 for exhalation, and 1.61 for humming.Conclusions: This study demonstrates that humming nasal NO increases after 2 weeks of oral steroid therapy for CRSNP. Humming NO is more sensitive than aspiration and exhalation and is associated with improvements in symptoms, polyp size, and quality of life. Humming NO may fill the niche for a noninvasive marker of sinus ostial patency. Ann Allergy Asthma Immunol. 2010;105:412-417.

    KW - Allergic rhinitis

    U2 - 10.1016/j.anai.2010.08.017

    DO - 10.1016/j.anai.2010.08.017

    M3 - Article

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    VL - 105

    SP - 412

    EP - 417

    JO - Annals of Allergy, Asthma & Immunology

    JF - Annals of Allergy, Asthma & Immunology

    SN - 1081-1206

    IS - 6

    ER -