05/08/2026
Paper of the Month: August 🌴
Systemic Corticosteroids in the Management of Sinonasal Disease: An Evidence-Based Expert Review
Thamboo A, Gigliotti D, De Corso E, et al.
International Forum of Allergy & Rhinology, Volume 16, Issue 8, pp. 852–879
Published 6 July 2026
DOI: 10.1002/alr.70211
https://onlinelibrary.wiley.com/doi/10.1002/alr.70211
This expert review provides a comprehensive, evidence-based appraisal of systemic corticosteroid (SCS) use across sinonasal disease, addressing indications where evidence is robust and where it is lacking.
Key points:
- Short-course SCS combined with intranasal corticosteroids shows durable benefit for olfactory dysfunction in CRSwNP, with improvements persisting up to 24 weeks in randomized data.
- Preoperative SCS in CRSwNP is well supported for reducing intraoperative bleeding, improving endoscopic visibility, and shortening operative time.
- No measurable benefit was found for postoperative SCS on sinonasal symptoms, endoscopic findings, or olfaction, including in comorbid asthma or NERD subgroups, while systemic toxicity risk rises with repeated exposure.
Clinical takeaway: SCS retain a defined role in select preoperative and short-term olfactory indications, but the evidence does not support routine postoperative use given the accumulating risk without added benefit.
