Effects of oral prednisolone and fluticasone nasal spray in the management of nasal polypi

Abstract

Background : Nasalpolyp presents a significant challenge in management due to its frequent recurrences. This study focuses on a medical model of combined local and systemic therapy for efficacy. Aims: Evaluation of a combined therapy, oral prednisolone, and fluticasone propionate nasal spray in the management of nasal polypi. Materials and Methods: This study was carried out in a tertiary care hospital in northeast India during a period of 18 months from 2010 to 2011. The recruitment of patients was done for 13 months and follow-up done for 3 months. The diagnosis made on the basis of physical examination, diagnostic nasal endoscopy, and radiological findings. The patients were evaluated for effects of combined treatment with fluticasone propionate nasal spray and oral prednisolone and followed up for 3 months. Descriptive statistics and analysis were carried out wherever applicable and P < 0.05 was considered statistically significant. Results: Altogether 67 patients were enrolled in this study. The most common presentation was observed in males in the fourth decade. With our modality, 98.5% showed a reduction in nasal obstruction score after treatment, and 83.6% showed a reduction in nasal discharge symptom score. Sixty patients (89.6%) showed a reduction in hyposmia symptom score after treatment and 68.7% showed a reduction in facial pain symptom score after treatment. Nasal polyp size was found to be significantly reduced after treatment, and no patients developed any adverse effects during or following the treatment initiation except mild burning sensation with fluticasone nasal spray (three patients) which subsided after a few days. Conclusion: We found that a 3-week course of combined oral prednisolone and fluticasone-propionate nasal spray is effective in decreasing polyp size and improving nasal symptoms for nasal polyposis, without sustained adverse effects.