Jean-Marc Norès1, Paul Avan, Pierre Bonfils. 1. Department of Otolaryngology, Head and Neck Surgery, European Hospital Georges Pompidou, 25 rue Leblanc, 75015 Paris, France.
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.
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.
Authors: Karen Head; Lee Yee Chong; Claire Hopkins; Carl Philpott; Anne G M Schilder; Martin J Burton Journal: Cochrane Database Syst Rev Date: 2016-04-26
Authors: Karen Head; Lee Yee Chong; Claire Hopkins; Carl Philpott; Martin J Burton; Anne G M Schilder Journal: Cochrane Database Syst Rev Date: 2016-04-26