Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Sun, Nov 15, 2026
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Volume 40, Issue 1 (1-2026)
Med J Islam Repub Iran 2026 |
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Rajaeih S, Emamgholizadeh Z, Jahandideh H, Mohebbi S. Investigating the Results of Using Betamethasone Ophthalmic Ointment in Polypoid Frontal Sinus in Endoscopic Sinus Surgery and Its Effect on Reducing the Recurrence of Polyposis After Surgery: A Randomized Clinical Trial. , Med J Islam Repub Iran. 2026; 40 (1) :888-895
URL: http://mjiri.iums.ac.ir/article-1-9172-en.html
URL: http://mjiri.iums.ac.ir/article-1-9172-en.html
ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran , emamgholizadeh.z@iums.ac.ir
Abstract: (287 Views)
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) often recurs after endoscopic sinus surgery (ESS), particularly in the frontal recess, which topical irrigations and sprays reach poorly. We evaluated whether intraoperative betamethasone ophthalmic ointment in the frontal sinus reduces postoperative recurrence.
Methods: In this randomized clinical trial with intra-patient control, 30 patients (≥13 years) with bilateral CRSwNP undergoing primary or revision ESS (Draf 2a) at 2 teaching hospitals in Tehran, Iran, were enrolled. One frontal sinus per patient was randomly assigned to betamethasone ophthalmic ointment at the end of surgery; the contralateral sinus served as control. Patients and outcome assessors were blinded. Polyps, inflammation, and secretion were assessed endoscopically at 1.5 and 3 months. The soft tissue density ratio (STDR) was measured on 3-dimensional CT reconstructions before and 3 months after surgery and analyzed with a generalized estimating equation model. Registration: Iranian Registry of Clinical Trials, IRCT20220510054810N1.
Results: The intervention side demonstrated significantly better endoscopic outcomes than the control side at both 1.5 months (no polyps: 93% vs 70%; no inflammation: 60% vs 20%; no secretion: 63% vs 17%) and 3 months (no polyps: 63% vs 50%; no inflammation: 67% vs 30%; no secretion: 63% vs 20%) (all P < 0.05). STDR reduction was also significantly greater on the intervention side (time × group interaction: β = −14.5, P < 0.001).
Conclusion: Intraoperative betamethasone ophthalmic ointment in the frontal sinus improved endoscopic outcomes at 1.5 and 3 months and reduced postoperative STDR, including in patients with Samter's triad. Larger trials with longer follow-up are warranted.
Methods: In this randomized clinical trial with intra-patient control, 30 patients (≥13 years) with bilateral CRSwNP undergoing primary or revision ESS (Draf 2a) at 2 teaching hospitals in Tehran, Iran, were enrolled. One frontal sinus per patient was randomly assigned to betamethasone ophthalmic ointment at the end of surgery; the contralateral sinus served as control. Patients and outcome assessors were blinded. Polyps, inflammation, and secretion were assessed endoscopically at 1.5 and 3 months. The soft tissue density ratio (STDR) was measured on 3-dimensional CT reconstructions before and 3 months after surgery and analyzed with a generalized estimating equation model. Registration: Iranian Registry of Clinical Trials, IRCT20220510054810N1.
Results: The intervention side demonstrated significantly better endoscopic outcomes than the control side at both 1.5 months (no polyps: 93% vs 70%; no inflammation: 60% vs 20%; no secretion: 63% vs 17%) and 3 months (no polyps: 63% vs 50%; no inflammation: 67% vs 30%; no secretion: 63% vs 20%) (all P < 0.05). STDR reduction was also significantly greater on the intervention side (time × group interaction: β = −14.5, P < 0.001).
Conclusion: Intraoperative betamethasone ophthalmic ointment in the frontal sinus improved endoscopic outcomes at 1.5 and 3 months and reduced postoperative STDR, including in patients with Samter's triad. Larger trials with longer follow-up are warranted.
: Original Research |
Subject:
Otorhinolaryngology
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