Efficacy of systemic steroid treatment in sinonasal polyposis

Nasal polyposis is an inflammatory disease of unknown origin. Systemic steroid treatment is effective not only in decreasing polyp size but also in controlling mucosal inflammation. We evaluated the efficacy of mean-term systemic corticosteroid treatment in nasal polyposis clinically and radiologically.

Seventy-five patients with nasal polyposis were included in this study. Patients were treated with methylprednisolone for 20 days. Clinical response was evaluated by nasal symptom scores and changes in polyp size; disease extent was assessed by paranasal sinus tomography. Nasal symptom score, polyp size, and disease extent were reevaluated after therapy.

Twenty-one (28%) of 75 patients were female, and 54 (72%) were male. The mean age was 41.63 ± 11.04 with a range of 17 to 80 years. As shown radiologically, 26.7% (n = 20) of patients completely healed, and 41.3% (n = 31) partially healed, whereas there was no improvement in 32% (n = 24). There was a statistically significant improvement in radiological assessment (P < 0.01). The sense of smell showed the greatest improvement (56.98%). The least-improved symptoms were facial pain and headache (37.74%). There was a statistically significant decrease in polyp grade (P < 0.01).

Systemic steroid treatment caused a decrease in all nasal symptoms and polyp size and improved paranasal computed tomography results. In addition, it shortened the duration of surgery and improved the quality of the procedure. Systemic steroid treatment also contributed to the prevention of recurrence.