Medical management of nasal polyposis; A study in a series of 152 consecutive patients

Abstract

Background: The management of nasal polyps is undoubtedly a controversial subject. The medical treatment remains the undisputed therapeutic mainstay but most of the publications are aimed at the registration of new molecules from the pharmaceutical industry which explains why they are confined to a single agent. Design: The aim of this study is focused on the evaluation of a dual modality on a series of 152 subjects treated according to a standardized protocol combining a short-term administration of prednisolone and the daily intranasal spraying of beclomethasone. Results: Over the follow-up period of one year, this modality proved to be successful in 68.5% of the subjects; only 31.5% had to undergo surgery after its failure. In the former group, after a six months period, the average symptom reduction reached an improvement rate varying from 35 to 80%, according to the symptom type. During the ensuing six months follow-up period, the improvement was maintained. The average utilization of prednisolone and beclomethasone was assessed for each individual patient. Conclusion: Management of nasal polyps should be primarily medical. Resorting to surgical procedures should not be envisaged before a six months trial of dual steroid therapy under strict compliance to treatment.