[Sino-nasal polyposis. Evaluation of the efficacy of combined local and general corticotherapy in a series of 100 consecutive patients with a 3-year follow-up]

Abstract

Nasal polyposis accounts for 40% of chronic nasal disease. The part played by surgery seems to be steadily growing if the number of publications dedicated to this approach is any yardstick. The medical treatment remains however the undisputed therapeutic mainstay but trials dedicated to the assessment of its overall efficacy are rather scarce. The aim of this study is focused on the evaluation of a dual modality, topical and systemic, over a follow-up period of three years. A total of 100 subjects were treated according to a standardized therapeutic protocol combining a short-term oral administration of a corticosteroid (prednisolone) and a daily intranasal spray of an other steroid (beclomethasone). Over the follow-up period of three years, this dual modality proved to be successful in 85% of the subjects; 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. Management of nasal polyps should be primarily medical. Resorting to surgical procedures should not be envisaged before a trial of dual steroid therapy under strict compliance to treatment. The single character of this long follow-up and the importance of the series of patients included in the protocol make all the originality of this work which shows for the first time the long-term improvement after medical treatment.