Improving the efficacy of functional endoscopic sinus surgery in chronic rhinosinusitis with nasal polyps through the combination of budesonide infiltration therapy.

BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a refractory inflammatory disorder often necessitating functional endoscopic sinus surgery (FESS) after inadequate response to medical therapy. This study aimed to evaluate the clinical efficacy and safety of combining FESS with intraoperative budesonide infiltration therapy in patients with CRSwNP. METHODS: A retrospective study was conducted from January 2022 to June 2024, including 209 CRSwNP patients. The observation group (n = 91) received FESS with intraoperative budesonide infiltration, while the control group (n = 118) underwent FESS alone. Clinical efficacy, olfactory function, mucociliary clearance, nasal ventilation function, complication rates, and recurrence were assessed. Data were analyzed using independent t-tests for continuous variables and Chi-square tests for categorical variables, with statistical significance set at p < 0.05. RESULTS: The observation group demonstrated significantly higher clinical efficacy, with a total effective rate of 87.91% compared to 66.95% in the control group (p < 0.001). Improvements were observed in olfactory function (1.08 ± 0.05 vs. 2.36 ± 0.18, p < 0.001), ciliary clearance rate (72.32 ± 6.05% vs. 66.24 ± 6.47%, p < 0.001), and ciliary clearance speed (5.51 ± 0.73 mm/min vs. 4.01 ± 0.73 mm/min, p < 0.001). Additionally, the incidence of complications was significantly lower in the observation group (4.40% vs. 12.71%, p = 0.04). No systemic corticosteroid-related adverse effects were observed. CONCLUSIONS: FESS combined with intraoperative budesonide infiltration therapy might improve olfactory recovery, nasal function, and overall clinical efficacy, while potentially reducing postoperative complications in CRSwNP patients, suggesting it could be a safe and effective adjunctive intervention.