EFFECTIVENESS AND SAFETY OF BUDESONIDE AS A POST-SURGERY TREATMENT FOR CHRONIC RHINOSINUSITIS: IMPLICATIONS FOR RESPIRATORY HEALTH IN SPORTS MEDICINE

Abstract

Background: Chronic rhinosinusitis (CRS) is a common inflammatory condition affecting the nasal and paranasal sinuses, significantly impairing respiratory function and quality of life. This systematic review and meta-analysis evaluated the efficacy and safety of budesonide as a local post-endoscopic sinus surgery (ESS) treatment for CRS, with potential implications for maintaining respiratory health in athletes and physically active individuals. Methods: Following PRISMA-2020 guidelines, randomized controlled trials (RCTs) published up to June 2024 were systematically reviewed from multiple databases. Eligible RCTs assessed the effectiveness of budesonide after ESS. Data extraction, quality assessment, and risk of bias evaluations were performed. Key outcomes included Sino-Nasal Outcome Test-22 (SNOT-22), Lund-Kennedy scores, nasal cycle volume, nasal airway diffusion capacity, nasal mucosal contact area, nasal resistance, and CRS recurrence rates. Results: The meta-analysis included eight RCTs comprising 630 patients. Budesonide treatment significantly improved SNOT-22 and Lund-Kennedy scores compared to control groups, reflecting enhanced patient-reported outcomes and endoscopic findings. Budesonide also improved nasal patency by reducing nasal resistance and nasal cycle volume while increasing nasal mucosal contact area. Additionally, CRS recurrence rates were markedly lower in the budesonide-treated group, indicating long-term therapeutic benefits. Conclusions: Budesonide as a local post-ESS treatment effectively improves nasal function, reduces inflammation, and lowers CRS recurrence risks. These findings suggest potential applications in sports medicine, where maintaining optimal respiratory health is crucial for athletic performance. Future research should explore budesonide’s role in managing exercise-induced rhinitis and respiratory disorders among athletes.