Recent Advances in Nasal Polyposis Treatment

PROGRAM DESCRIPTION: Management options for the nasal polyp will be based on the endotype and phenotype. It is recommended that intranasal corticosteroids and nasal saline irrigations be tried for about two to three months as an initial treatment for patients with chronic rhinosinusitis and nasal polyposis. A safe and inexpensive way to improve the clearance of antigens, biofilms, and inflammatory mediators is using high-volume, low-pressure nasal saline irrigations. Nose congestion and polyp size can be enhanced with intranasal corticosteroids. Otolaryngologists disagree on the optimal time to perform functional endoscopic sinus surgery (FESS) for CRSwNP. However, it is often considered when medication treatment fails to alleviate symptoms to a sufficient level. After a CRSwNP procedure, treating the patient with topical intranasal steroids is crucial. Even while surgery can relieve symptoms by removing the physical blockage and reestablishing normal mucosal drainage, treating the underlying cause of allergies is still necessary. Formal allergy testing, targeted immunotherapy, topical antihistamines, and nasal steroids are the mainstays, with or without topical antihistamines (1).
Only corticosteroids have been shown to reduce polyp size successfully. When applied orally and topically, they alleviate nasal blockage symptoms and shrink polyps through a nonspecific anti-inflammatory reaction. The treatment of nasal polyps involves the use of leukotriene receptor antagonists (2).

Recently, refractory disease can be treated with biological medications known as monoclonal antibodies. Bilateral nasal polyps, severe anosmia, poor quality of life, asthma, the requirement for systemic steroids or a contraindication to these, or signs of type II inflammation (eosinophilia >250 cells/microliter, blood IgE >100 UI/mL, or tissue eosinophils >10 HPF) are all necessary criteria for biologic drug candidates. Patients with EGPA or CF, which are systemic diseases, should get treatment for the underlying ailment if they develop nasal polyps.