{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:57:07Z","timestamp":1790888227196,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The indication for nasal irrigation with corticosteroids after sinus surgery in patients with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) is well established, as surgery facilitates distribution throughout the sinonasal cavity. However, it remains unknown whether this approach could also provide therapeutic benefit prior to surgery. This study aims to compare the effect of budesonide versus saline nasal irrigation in surgically naive CRSwNP patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomized, double\u2010blind, placebo\u2010controlled parallel\u2010group study was conducted in 52 patients with diffuse type 2 CRSwNP with no previous sinus surgery. Patients were randomized to receive either 1\u00a0mg budesonide or saline nasal irrigation twice daily for four weeks. The primary outcome was the change in the 22\u2010item Sinonasal Outcome Test (SNOT\u201022). Secondary outcomes included the Visual Analogue Scale (VAS), Nasal Polyp Score (NPS), and the Connecticut (CCCRC) olfactory test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 52 patients were randomized (mean age 50.1 \u00b1 12.9 years; 51.9% female). The intention\u2010to\u2010treat (ITT) analysis showed that the budesonide nasal irrigation group demonstrated a significantly greater improvement in SNOT\u201022 (mean difference: 18.1 points [95% CI: 3.4 to 32.8;\n                      <jats:italic>p =<\/jats:italic>\n                      0.017]), VAS (mean difference 2.24 points [95% CI: 0.35 to 4.13;\n                      <jats:italic>p =<\/jats:italic>\n                      0.018]) and NPS (mean difference: 0.73 points [95% CI: 0.25 to 1.21];\n                      <jats:italic>p =<\/jats:italic>\n                      0.003). No significant differences were observed between groups in CCCRC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Budesonide nasal irrigation may be an important tool for controlling sinonasal symptoms in patients with CRSwNP who are not candidates for sinus surgery or while awaiting surgical treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70112","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T17:20:29Z","timestamp":1771003229000},"page":"681-688","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Budesonide Nasal Irrigation in Patients With Chronic Rhinosinusitis With Nasal Polyps Without Prior Sinus Surgery: A Randomized, Double\u2010Blind, Placebo\u2010Controlled Study"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5762-9801","authenticated-orcid":false,"given":"Juliana","family":"Sant'Ana","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Santa Casa of S\u00e3o Paulo School of Medical Sciences  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela","family":"Pontes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Santa Casa of S\u00e3o Paulo School of Medical Sciences  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caio","family":"Floriano","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Santa Casa of S\u00e3o Paulo School of Medical Sciences  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Rios","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Santa Casa of S\u00e3o Paulo School of Medical Sciences  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlos","family":"Cortez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Santa Casa of S\u00e3o Paulo School of Medical Sciences  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8485-0496","authenticated-orcid":false,"given":"Marcel","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Santa Casa of S\u00e3o Paulo School of Medical Sciences  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010020\u201000218\u20101"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2016.04.012"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin20.401"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2000.110038"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e7054"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.04.020"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22093"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.0667"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11095\u2010022\u201003375\u2010y"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12070\u2010023\u201004173\u20107"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2021.06.008"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1808-86942011000500021"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.118012"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102222.2009.03381.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894231177769"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin18.122"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin22.011"},{"key":"e_1_2_9_19_1","first-page":"183","article-title":"Staging in Rhinosinusitus","volume":"31","author":"Lund' V. 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