Corticosteroid Treatment in Nasal Polyposis With a Three-Year Follow-Up Period

Pierre Bonfils, MD, PhD; Jean-Marc Norès, MD, PhD; Philippe Halimi, MD; Paul Avan, MD, PhD

Objectives/Hypothesis:
The management of nasal polyposis is undoubtedly a controversial subject. The part played by surgery seems to be steadily growing, if the number of published reports dedicated to this approach is any yardstick. Although the medical treatment remains the undisputed therapeutic mainstay, trials dedicated to the long-term assessment of its overall efficacy are scarce.

Study Design:
Retrospective medical record review.

Methods:
The aim of the study is focused on the evaluation of a dual modality, topical and systemic, over a follow-up period of 3 years. In all, 100 patients were treated according to a standardized therapeutic protocol combining short-term oral administration of prednisolone and daily intranasal spray of beclomethasone.

Results:
Over the follow-up period of 3 years, this dual modality proved to be successful in 85% of the patients; only 15% had to undergo surgery after its failure. The average symptom reduction reached an improvement rate varying from 58% to 80%, according to the symptom type. The daily dosage of prednisolone and beclomethasone was progressively decreased while the gain in nasal comfort was being preserved.

Conclusions:
Management of nasal polyps should be primarily medical. Resorting to surgical procedures should not be envisaged before a trial is conducted of dual steroid therapy under a regimen of strict compliance to treatment.

Key Words: Nasal polyposis; nasal polyps; corticosteroid; prednisolone; beclomethasone