controlled study evaluating medical treatment versus surgical treatment in addition to medical treatment of nasal polyposis

ABSTRACT

Thirty-two patients with nasal polyposis and symmetrical nasal airways were randomized to unilateral endoscopic sinus surgery after pretreatment with oral prednisolone for ten days and local nasal budesonide bilaterally for one month. Postoperatively, the patients were given local nasal steroids [budesonide]. They were evaluated with nasal endoscopy, symptom scores and olfactory thresholds. They were followed up for 12 months. The sense of smell was improved by the combination of local and oral steroids. Surgery had no additional effect. The symptom scores were significantly increased with the medical treatment alone, but surgery had additional beneficial effects on nasal obstruction and secretion. After surgery, the polyp score decreased significantly on the operated side, but remained the same on the unoperated side. 25% of the patients were willing to undergo an operation also on the unoperated side at the end of the study. The medical treatment proved to be sufficient to treat most of symptoms of nasal polyposis