Our Summary

This research paper is a systematic review of different methods for delivering intranasal corticosteroids to treat chronic rhinosinusitis with nasal polyps, a condition that causes inflammation and swelling in the nasal cavity and sinuses. The researchers looked at studies from four databases, published from 1980 to 2024, and narrowed down over 2000 studies to just five that met their specific criteria.

They found that using a nebulizer, aerosol spray, or nasal drops to deliver the medication was just as effective as taking oral corticosteroids, but these methods were safer and had less side effects. However, they also found that using an aqueous spray, a spray that uses water to deliver the medication, was less effective than the other methods, but still showed improvement if used consistently over a long period of time.

So, the researchers concluded that non-aqueous methods like nebulizers, aerosol sprays, and nasal drops are a safer alternative to oral corticosteroids for treating this condition without causing other health problems. They also suggested that patients using aqueous sprays should be counseled on the importance of sticking to their treatment plan for the long term to see improvement in their symptoms.

FAQs

  1. What are some effective methods for delivering intranasal corticosteroids to treat chronic rhinosinusitis with nasal polyps?
  2. Are there any side effects associated with using a nebulizer, aerosol spray, or nasal drops for treating this condition?
  3. What should patients using aqueous sprays be aware of in their treatment plan?

Doctor’s Tip

One helpful tip a doctor might give to a patient about nasal polyp removal is to follow their post-procedure care instructions carefully. This may include avoiding activities that could irritate the nasal passages, such as blowing the nose too forcefully, and using any prescribed medications or nasal sprays as directed. It is also important to attend follow-up appointments to monitor progress and address any concerns. Additionally, maintaining good nasal hygiene, such as using a saline rinse, can help prevent the recurrence of nasal polyps.

Suitable For

Patients who are typically recommended nasal polyp removal are those who have tried other treatments such as intranasal corticosteroids and have not seen improvement in their symptoms. Nasal polyp removal may be recommended for patients who have severe symptoms such as difficulty breathing, persistent nasal congestion, loss of smell, frequent sinus infections, and facial pain or pressure.

Patients who have nasal polyps that are large, causing obstruction of the nasal passages, or are causing complications such as sinus infections or asthma may also be recommended for removal. Additionally, patients who have tried other treatments and continue to experience symptoms that significantly impact their quality of life may be candidates for nasal polyp removal.

It is important for patients to consult with their healthcare provider to determine the most appropriate treatment plan for their specific condition. Nasal polyp removal may be recommended in conjunction with other treatments such as intranasal corticosteroids to provide the best outcome for the patient.

Timeline

Timeline:

  1. Before nasal polyp removal:
  • Patient experiences symptoms such as nasal congestion, loss of smell, facial pain or pressure, runny nose, and postnasal drip.
  • Patient may undergo diagnostic tests such as a nasal endoscopy or CT scan to confirm the presence of nasal polyps.
  • Patient may be prescribed intranasal corticosteroids to reduce inflammation and swelling in the nasal cavity.
  • Patient may also be advised to avoid triggers such as allergens or irritants that can exacerbate symptoms.
  1. Nasal polyp removal procedure:
  • Patient undergoes nasal polyp removal surgery, which can be done endoscopically or through traditional surgery.
  • During the procedure, the surgeon removes the nasal polyps and may also widen the sinus passages to improve airflow.
  1. After nasal polyp removal:
  • Patient may experience some pain, swelling, and congestion in the nose and sinuses immediately after the surgery.
  • Patient will be prescribed pain medications and nasal sprays to help with healing.
  • Patient will have follow-up appointments with their surgeon to monitor healing and ensure proper recovery.
  • Patient may need to continue using intranasal corticosteroids to prevent recurrence of nasal polyps and manage inflammation in the nasal cavity.
  • Patient should follow post-operative care instructions, such as avoiding strenuous activities, blowing their nose gently, and keeping the nasal passages clean and moist.

Overall, nasal polyp removal can provide relief from symptoms and improve quality of life for patients with chronic rhinosinusitis. However, it is important for patients to continue managing their condition with medication and regular follow-ups with their healthcare provider to prevent recurrence of nasal polyps.

What to Ask Your Doctor

Some questions a patient should ask their doctor about nasal polyp removal include:

  1. What are the risks and benefits of nasal polyp removal surgery?
  2. What is the recovery process like after nasal polyp removal surgery?
  3. How long will it take to see improvement in my symptoms after the surgery?
  4. Are there any alternative treatments to nasal polyp removal that I should consider?
  5. What are the potential complications or side effects of nasal polyp removal surgery?
  6. How often do nasal polyps typically recur after removal surgery?
  7. Will I need to follow a specific post-operative care plan or take any medications after the surgery?
  8. Will I need any follow-up appointments or tests after the surgery?
  9. How can I prevent nasal polyps from recurring in the future?
  10. Are there any lifestyle changes or home remedies that can help manage nasal polyps after surgery?

Reference

Authors: Gurevich RE, Bakare AB, Levy DA, McCoul ED. Journal: Otolaryngol Head Neck Surg. 2025 May;172(5):1502-1511. doi: 10.1002/ohn.1147. Epub 2025 Feb 3. PMID: 39898602