A randomized prospective study comparing medical and medical-surgical treatment of nasal polyposis by CT

Abstract

Conclusions: CT of the sinuses showed long-lasting improvement in the total and CT scores of the osteomeatal complex (OMC) after combined surgical and corticosteroid treatment as compared with medical treatment alone. However, the correlations between the improved CT scores and the patients' symptoms, olfactory thresholds or polyp scores were generally not significant.

Objective: To evaluate CT scans as a method for comparing the effect of medical treatment versus combined surgical and medical treatment of nasal polyposis.

Patients and methods: Thirty-two patients with nasal polyposis were randomized to unilateral endoscopic sinus surgery after pretreatment with oral prednisolone for 10 days and nasal budesonide bilaterally for 1 month. Postoperatively, they were given nasal steroids (budesonide) bilaterally for 1 year. They were assessed with nasal endoscopy, symptom scores, and olfactory thresholds and followed for 12 months. CT of the sinuses was performed before and 1 year after operation. The CT scans were evaluated using the Lund staging system.

Results: From before surgery to 1 year after surgery, we found a significant improvement on the operated side in the CT total scores, and scores of the OMC and the maxillary sinus, but no significant differences on the unoperated side. Significant correlations were also noted between the differences in olfactory thresholds between the operated and unoperated sides.