Management of Nasal Polyps by Steroid Nose Drops

Abstract
Systemic steroids may remove symptoms from nasal polyps in most patients, while surgery only is necessary in a few resistant cases. However, topical medication is preferable. Sprays may prevent recurrencies, but they seldom suffice for removing polyps. The aim of the present study was to document clinical efficacy of steroid nose drops. In 24 patients with nasal polyps documented by mini biopsy, aqueous budesonide (Rhinocort Aqua, Draco, Sweden) was applied as nose drops. Every second day 0.25 ml was instilled in each nostril with the head down and forward. Conventional spraying was done twice daily. The clinical condition, nasal expiratory peak flow, and sense of smell was monitored for at least two months. The frequency of applying drops was decreased if smell returned or polyps disappeared while spraying continued. A few patients were not able to comply, and a few noticed insignificant nasal bleeding. In most cases the patients were satisfied after two or three months of treatment. It is concluded that in many patients nasal polyps can be managed by budesonide nose drops. However, the results of the present pilot study should be confirmed by controlled trials before routine clinical use is justified.