Journal Reading
The Efect o Preoperative Short Course o Oral Steroids ollowed by
Postoperative Topical Nasal Steroids Sprays on Nasal Polyp
Recurrence ater Endoscopic Nasal Polypectoy
 
 
• Nasal polyps  Oedeatous sot tissue outgrowths o the nasal ucosa and paranasal sinuses!
• "acroscopic characteristic# sooth$ shiny$ pin% or grey surace
• "icroscopic characteristic# oedeatous stroa covered by respiratory or etaplastic s&uaous cell epitheliu!
• "anageent options# edical or surgery or cobined
 
• Nasal polyp oration and growth are still unclear and the role o allergy is controversial!
 
infiltration of inflammatory cells !mast
cells " eusinopills#
mucosa
mast cells
o, nasal %ucosa
#reatly ,acilitates the
access and %a'es
the o$eration easier
 – In,ection
 The age of the patients ranged from 18 to 60
years Patients were divided into two
groups
symptoms and signs of nasal polyps were
included in this study.
Ear !ose Throat "E!T# $epartment at $ha%a national medical college &
hospital
polypectomy *itout preoperati%e oral and
postoperati%e local steroid terapy+
() patients treated by endoscopic nasal
polypectomy *o recei%ed preoperati%ely
,- mg prednisolone tablets daily in tree
e.ual di%ided doses !(- mg / 0# for one
*ee1 and postoperati%ely by topical nasal
steroid spray !'ometasone
metered doses in eac nostril t*ice daily
!total daily dose )-- mcg# for one mont
ten reduced to t*o metered doses in eac
nostril once daily !total daily dose (--mcg#
for t*o monts
 
least one year2 Recurrence o, nasal
$oly$s was assessed
%onths a,ter sur#ery2 &ny e)idence
o, nasal $oly$ ,or%ation o, any size
was considered as a recurrence
&ll $atients underwent ,ull
%edical e8a%ination includin#
u$$er airway endosco$y4 chest
• &atientss *it sinonasal polyposis *o under*ent endoscopic nasal polypectomy+
IN/;SI"N /RITERI& 
• &atients *it istory of pre%ious nasal polypectomy3 ypertension3 gastric problems3 diabetes mellitus3 cystic fibrosis3 allergic fungal sinusitis3 aspirin intolerance3 erpes 1eratitis3 glaucoma3 psyciatric disorders3 ad%anced osteoporoses and tuberculosis *ere excluded from tis study+
E9/;SI"N
/RITERI& 
• )4 patients !0( males and 5, females# *it sinonasal polyposis
*ere included in tis study
• Table I2 Symptoms of nasal polyps at presentation !N6)4#
  P a t i e n t s   % 
 Nasal obstruction  40  83.3  R h i n o r r h e a   36  75 
Recurrent URTI  32  66.6  Sneezin  30  62.5 
!ostnasal "ischare  28  58.33  #ea"ache  26  54.$6 
 
S RATE
.roup 3  4  6!11  2  47  38  93!2 
.roup 4  
nu%ber o, recurrences o, nasal
$oly$s a,ter one year in the
second #rou$ in co%$arison with
the ,irst #rou$2 The $oly$s< size4
nu%ber and s$eed o, #rowth were
s%aller in rou$ II $atients which
resulted in better nasal airways
and %ore satis,action ,ro%
I2
 
o, acti)ely treated $atients
the $lacebo #rou$2 
intranasal steroid =,luticasone
$ro$ionate> a,ter endosco$ic
BB2BA in control #rou$>4 but also
it is a sa,e and reliable and does
not increase the $re)alence o,
in,ection2