Management of early nasal polyposis using a steroid-impregnated nasal dressing

Oral corticosteroids are the mainstay of medical management of sinonasal polyposis. However, systemic steroid-related side effects can be significant in both the short-term and long-term. Topical targeted steroids in optimal concentrations to the affected mucosa present an attractive alternative. The objective of this study was to compare the efficacy of steroid impregnated absorbable nasal dressing with oral steroids in the management of early nasal polyposis after endoscopic sinus surgery.

A total of 21 symptomatic patients with nasal polyposis presenting with endoscopic findings of early polyposis received triamcinolone-impregnated (20 mg/mL) nasal dressing (Nasopore; Stryker Canada). A control group of 20 similar patients were treated with a short course of oral steroids. Evaluation was based on Sinonasal Assessment Questionnaire (SNAQ-11) and Perioperative Sinus Endoscopy (POSE) score at baseline, 4-week, and 8-week follow-up intervals.

At baseline, 4 weeks, and 8 weeks mean SNAQ scores were 18.42, 8.76, and 9.42 in the study group and 19.35, 7.15, and 7.60 in the control group, respectively. Mean POSE scores were 12.14, 5.04, and 6.04 in the study group and 13.52, 5.01, and 5.52 in the control group, respectively. No significant difference was found between the groups at 4 and 8 weeks in either SNAQ (p = 0.129, p = 0.235) or POSE (p = 0.803, p = 0.795) scores.

Triamcinolone-impregnated absorbable nasal dressing is comparable to oral steroids in the management of early nasal polyposis after sinus surgery.