efficacy of clarithromycin in patients with severe nasal polyposis

Although several treatments have been suggested for nasal polyposis, from medical to surgical, there is no standard guideline for the management of this disease. During recent years increasing attention has been directed toward the effects of macrolide antibiotics on chronic sinusitis and nasal polyposis. In this study, the efficacy of clarithromycin on severe nasal polyposis were examined. In a Prospective, before -after study, forty patients with severe nasal polyposis received clarithromycin 500 mg twice a day for 8 weeks. At the beginning and end of treatment, the severity of patients' symptoms [using subjective analogue scale], computed tomography [CT] scan and endoscopic findings were recorded. After treatment, the severity of nasal obstruction, smelling problems, Post Nasal Discharge and rhinorrhea decreased significantly [P0.05]. Furthermore, the degree of sinus opacification in CT scan and endoscopic findings showed significant improvement. Most patients completed their treatment course without significant side effects. Although a course of clarithromycin improved nasal symptoms, polyp size and CT findings, further studies with more patients are required to recommend this drug as a general treatment in nasal polyposis

Endoscopic endonasal surgery for resection of benign sinonasal tumors experience with 107 patients

The use of endoscopic surgery for nasal and sinus pathologies has revolutionized our approaches towards the diseases of these areas. To report our experience with endoscopic surgery of benign tumors and tumor-like conditions of the nose and paranasal sinuses. The medical records of 105 patients with benign sinonasal tumor, who had undergone endoscopic surgery for removal of their neoplasm between 1997 and 2003, were retrospectively studied. The studied patients included 32 with juvenile nasopharyngeal angiofibroma, 24 with inverted papilloma, 23 with benign fibroosseous lesions, 18 with pyogenic granuloma, 6 with intranasal hemangioma, and 2 with pleomorphic adenoma. The patients had a follow-up ranging from 9 to 73 [mean: 41] months. During the follow-up period, the patients were under close observation by performing serial endoscopy and yearly CT scan. Eight cases of recurrent tumor-2 angiofibroma, 4 inverted papilloma, 1 fibrous dysplasia, and 1 osteoma-were noted and managed endoscopically alone or in combination with Caldwell-Luc approach. The major complication encountered in this study was cerebrospinal fluid leakage [2 cases] that was sealed intra-operatively with local tissue flaps without any further sequela. Endoscopic surgery is a valuable tool for removal of benign tumors of the nose and paranasal sinuses in the hands of an experienced surgeon