{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T23:36:51Z","timestamp":1788565011185,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100010804","name":"Faculty of Medicine, Prince of Songkla University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the efficacy of corticosteroid irrigation (CSI) and intranasal corticosteroid spray (INCS) in reducing polyp size, improving nasal symptoms, and assessing HPA\u2010axis suppression in non\u2010surgical patients with chronic rhinosinusitis with nasal polyps (CRSwNP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010four patients from the Allergy and Rhinology Clinic, Songklanagarind Hospital, were randomized into: CSI\u2009+\u2009placebo spray (<jats:italic>n<\/jats:italic>\u2009=\u200913): Budesonide irrigation (0.5\u2009mg\/day)\u2009+\u2009saline spray. Placebo irrigation\u2009+\u2009INCS (<jats:italic>n<\/jats:italic>\u2009=\u200911): Saline irrigation\u2009+\u2009budesonide spray (512\u2009mcg\/day). Nasal symptoms were assessed using VAS\u2010TNSS and SNOT\u201022. Polyp grading was evaluated via video nasal endoscopy using mLKS and Lildholdt's scale. Serum cortisol levels were measured at baseline, 4\u201312\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 12\u2009weeks, the CSI\u2009+\u2009placebo spray group showed a significant reduction in mLKS scores (8.54\u2009\u00b1\u20091.94 vs. 4.82\u2009\u00b1\u20091.94; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with greater improvement than the placebo irrigation\u2009+\u2009INCS group (\u03944 (3, 4) vs. \u03941 (0, 2); <jats:italic>p<\/jats:italic>\u2009=\u20090.003). VAS\u2010TNSS and SNOT\u201022 scores showed no significant differences. Serum cortisol levels remained normal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Corticosteroid irrigation is more effective than nasal sprays in improving mLKS scores in non\u2010surgical CRSwNP patients after 12\u2009weeks, with no evidence of HPA\u2010axis suppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.32250","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T08:48:16Z","timestamp":1746607696000},"page":"3550-3555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Randomized, Double\u2010Blind Study Comparing Corticosteroid Irrigations and Nasal Sprays for Polyp Size Reduction in <scp>CRSwNP<\/scp>"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3073-7789","authenticated-orcid":false,"given":"Chakapan","family":"Promsopa","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Faculty of Medicine, Prince of Songkla University  Songkhla Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanapa","family":"Quannuy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Faculty of Medicine, Prince of Songkla University  Songkhla Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchet","family":"Chinpairoj","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Faculty of Medicine, Prince of Songkla University  Songkhla Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3338-8975","authenticated-orcid":false,"given":"Virat","family":"Kirtsreesakul","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Faculty of Medicine, Prince of Songkla University  Songkhla Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usaporn","family":"Prapaisit","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Faculty of Medicine, Prince of Songkla University  Songkhla Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichana","family":"Suwanparin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Faculty of Medicine, Prince of Songkla University  Songkhla 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