Medical Treatment of Nasal Polyposis

Abstract

Nasal polyps cause nasal blockage, runny nose, and decrease in or loss of olfaction, but their etiology is actually not known. The treatment of chronic rhinosinusitis (CRS) with nasal polyposis is directed at dealing with these symptoms, and consists of both surgical and medical remedies; nevertheless there is no treatment protocol that is universally recognized. The treatment of nasal polyps depends on the etiologic elements. However, in the majority of cases, this is not clear. Even when the patient has allergic background, no clinical proof demonstrates that the treatment of these allergies could minimize or eradicate polyps. Since the main etiology in the majority of cases is inflammation, medical treatment consists of nonspecific therapies for this inflammation related problem. Nasal corticosteroid sprays may diminish or slow down the development of small nasal polyps; nevertheless they are rather not effective in massive nasal polyposis. Intranasal steroids are most beneficial in the postoperative interval to protect against or slow down regrowth of the polyps. Oral steroids are one of the mainstays for the medical treatment of nasal polyposis. Antibiotics, anti-IgE, anti-IL-5, antihistamines, antimycotics (topical amphotericin B), furosemide, immunosuppressants, leukotriene antagonists, Aspirin desensitization, capsaicin, nasal decongestants, mucolytics, postoperative saline douches or spray, manuka honey, and proton pump inhibitors are also used. In this chapter, alternatives of medical treatment for nasal polyposis are described.