The Observation Of Postoperative Efficacy Of Topical Glucocorticoid In The Patients With Otolaryngology Diseases

Objective:By comparing the local glucocorticoids(in this experiment was budeson-ide) and systemic corticosteroids(dexamethasone for example) in chronic suppurative otitis media,chronic sinusitis and nasal polyps,OSAHS and vocal cord polyp,vocal nodules Observeing the efficacy of local glucocorticoid at the treatment of postoperative diseases.Methods:From our hospital patients:1.Selecting 34 cases(36 ears) patients with mastoid lesion excision and tympanoplasty, they were randomly divided into three groups,budesonide(Pulmicort) group, dexamethasone group and control group.Taking the ear gauze off when the 12 day after operations,budesonide group was changed the dressing with Pulmicort Respules(1mg) which mixed antibiotic drops 10ml(Ofloxacin),once a day.Dexamethasone group was changed the dressing with dexamethasone 5mg which mixed the same antibiotic drip,the control group was simply changed dressing with antibiotic drops.Observing and comparing the time of no exudation of wound in three groups of patients.2.Selecting 34 cases patients with chronic sinusitis and nasal polyps of bilateral and similar conditions on both sides,all patients were selected the left side as budesonide group,the right was the dexamethasone group,They were the initial surgery patients,according to the scope of lesions,location and severity,respectively,they were implemented by the same technique of functional endoscopic sinus surgery,all patients were extracted nasal swab and stopped bleeding with packing in the first two days.In the 7 days,all patients were contracted the nasal mucosa with 1%ephedrine cotton,other conventional treatments were same.Cleaning the sinus weekly and when endoscopic sinus inspections,budesonide group was sprayed budesonide to the surface of mucosa in the sinus,dexamethasone group was sprayed dexamethasone insteadly.3.Selecting the sleep apnea-hypopnea syndrome(OSAHS) patients 28 cases,the patients were randomly divided into two groups,one group for the budesonide group,another was dexamethasone group,they were experienced the same operations(UPPP).After operations,budesonide group was inhalated with Gentamicin 8~u and 2ml Pulmicort Respules,1 times a day,7 days.Dexamethasone group was inhalated with the same volume of Gentamicin and dexamethasone 5mg,1 times a day,7 days.More than the same treatment,patients were observed the disappearrance time of pharynxgodynia,edema and length of stay in hospital.4.Selecting 30 cases patients with vocal cord polyp,18 cases patients with vocal nodules.The patients were randomly divided into two groups,namely budesonide group and dexamethasone group,All patients undered polyps or vocal nodules surgery after operations,budesonide group was inhalated Gentamicin 8~u and 2ml Pulmicort Respules,1 times a day,7 days.Dexamethasone group was inhalated with the same volume of Gentamicin and dexamethasone 5rag,1 times a day,7 days.The two groups were observed the time of throat discomfort,hoarseness symptom and length of stay in hospital.Results:1.The average time to do ear after operations of the patients of Control group was 26.09±5.38 days,the dexamethasone group was 21.5±5.16 days after operations,the time to do ears of budesonide group was shorter than the previous two groups,it was 17.76±3.37 days.Comparing three groups and fouding that they were statistically significant(P＜0.05).2.Budesonide group:The process of epithelial more quickly than dexamethasone group,all patients after topial treatment and integrated treatment were cured for 97.05%,improved 2.94%,and the average time of epithelization was 42.82 days.Dexamethasone group:The process of epithelial in budesonide group extened than Budesonide group.The cure rate was 94.1 percent and the improvement was 5.88%,the average time for epithelization was 50.03 days.Comparing the two groups and fouding that they were statistically significant(P＜0.05).3.The two groups showed:The disappeared time of pharyngodynia,edema,and length of stay in hospital of the patients in the budesonide group were shorter than dexamethasone group.The disappeared time of pharyngodynia of budesonide group was about 8.4 days,edema disappeared time was about 8.1 days,hospitalization time was 10.3 days.The disappearance of time of pharyngodynia of dexamethasone group:was 11.0 days,edema disappearance time was 11.35 days,hospitalization time was 13.35 days.After statistical analysis,the two groups were significant differences.(P ＜0.05)4.The disappeared time of throat discomfort,hoarseness and length of stay in hospital of budesonide group were shorter than dexamethasone group,the disappearance time of throat discomfort of budesonide group was about 5.21 days,hoarseness disappeared was about 7.21 days,hospitalization time was 7.46 days;The disappearance time of throat discomfort of dexamethasone group was about 9.5 days,hoarseness disappearance time was11.0 days, hospitalization time was 10.0 days.After statistical analysis,the two groups were significant differences.(P＜0.05).Conclusion:1.Topical application of glucocorticoids may be effective to reduce the inflammatory response of chronic suppurative otitis media,chronic sinusitis and nasal polyps,OSAHS and vocal cord polyp,vocal nodules which after.operations.2.Topical glucocorticoid are more effective in the control of local inflammatory response than systemic glucocorticoids,it could be used widely.