Management of Nasal Polyposis

Abstract Introduction Nasal diffuse bilateral polyposis associated with allergic rhinitis (AR) represent a hypertrophy of nasal mucosa usually the result of a chronic or allergic inflammation. The aim of the study is to present the therapeutic management, medical and surgical modalities in the treatment of 52 cases with NP and allergic rhinitis (AR).

Material and Method The diagnosis of nasal poliposys associates with AR includes the predominant symptoms, X-ray examination, CT scan of paranasal sinuses, endoscopic examination, MR with gadolinium, skin tests, laboratory (immune response-eosinofilic allergic inflammation), diagnostic biopsy. Endoscopic sinus surgery (ESS) was performed in 48 cases (polypectomy, uncinectomy, partial turbinectomy, antrostomy) under control with a 0^o, 30^o, 70^o endoscopes. The simple polypectomy without resection of ethmoidal and maxillary sinuses mucosa was applied in 4 selected cases.

Results Mean follow-up period was 24 months ranged from 12 -24 months with minimal morbidities and patients comfort. No recurrence of disease was observed in our ESS series (48 cases).The QoL improved after surgery even if the polyps recurred and repeated surgery was necessary. Postoperative effective and rapid normalization of nasal symptoms (nasal obstruction, nasal blockage, nasal discharge, hyposmia or anosmia, rhinorrhea, sneezing, itching) were improved significantly.

Conclusions Total removal of the polyps and paranasal lining is necessary and represent an accurate and proper treatment. Endoscopic sinus surgery associated usually with intranasal antihistamines and corticosteroid (INS) is the first choice option therapy for nasal polyposis with allergic rhinitis.

Keywords nasal polyposis, endoscopic sinus surgery, antihistamines and corticosteroid (INS)

Publication History

Article published online:
10 June 2020