Purpose Of Review: To review treatment options for sinonasal polyps, focusing on the role of steroids and, specifically, intrapolyp steroid injection. History of steroid injections, comparison to other medical and surgical treatments, as well as the risks and safety of injections are all discussed.
Recent Findings: A panoply of methods exists to treat sinonasal polyps. Recently, studies have begun to elucidate the pathophysiology of polyp formation as well as the specific mechanisms by which steroids act to reduce polyp formation. Steroids can be delivered orally, topically or via injection directly into the polyp. Each of these methods offers different advantages and disadvantages, which are reviewed in this paper.
Summary: Sinonasal polyps can have a severe affect on patients' quality of life. While there are several tools available to the otolaryngologist to help manage these polyps, steroids remain the cornerstone of medical therapy for this condition. Traditionally, steroids have been delivered systemically via oral medication or locally via topical washes and sprays. Steroid injection represents a potential method to deliver a high concentration of this antiinflammatory medication to a local area. Over the years, intranasal steroid injections have come in and out of favor. Here, we review the various management options for sinonasal polyps, and focus on existing data regarding intrapolyp steroid injections.
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http://dx.doi.org/10.1097/MOO.0b013e3282f1c7d0 | DOI Listing |
Am J Otolaryngol
December 2024
University of Illinois Chicago College of Medicine, Department of Otolaryngology-Head and Neck Surgery, 1853 W Polk St, Chicago, IL 60612, USA.
Background: Environmental exposures may be associated with increased severity of chronic rhinosinusitis (CRS). However, research examining associations of traffic related air pollution with CRS is limited. The purpose of this study was to determine the association between residential traffic proximity and CRS with nasal polyposis (CRSwNP) severity in an existing database of adults in the United States.
View Article and Find Full Text PDFJ Pers Med
December 2024
Radiological Sciences Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, AOUP "Paolo Giaccone", Via del Vespro 129, 90127 Palermo, Italy.
Nasal and paranasal sinus masses can arise from a wide range of conditions, both benign and malignant, as well as congenital or acquired. Diagnosing these masses is often challenging, requiring a combination of nasal endoscopy, imaging studies, and histopathological analysis. Initial imaging frequently involves computed tomography or cone beam computed tomography (CBCT) to evaluate the bony anatomy of the nasal cavity and surrounding sinuses, while magnetic resonance imaging (MRI) is typically used for detailed assessment of soft tissues and to aid in differential diagnosis when the findings are inconclusive.
View Article and Find Full Text PDFInt Forum Allergy Rhinol
December 2024
Center of Excellence in Otolaryngology-Head & Neck Surgery, Rajavithi Hospital, Bangkok, Thailand.
Introduction: Tissue eosinophil count (TEC) is recommended for defining Type 2 chronic rhinosinusitis with nasal polyps (CRSwNP). TEC is usually assessed by a one-time polyp biopsy. Because TEC may change over time, its reliability for diagnosing type 2 CRSwNP has not been previously assessed.
View Article and Find Full Text PDFRhinology
December 2024
Department of Otorhinolaryngology, CHU Hôtel Dieu, Nantes, France.
Background: Clinical trials have demonstrated the effectiveness of biologics in treating chronic rhinosinusitis with nasal polyps (CRSwNP). However, real-world evidence regarding patient outcomes and predictors of clinical response remains limited.
Methodology: In this multicentric 18-month follow-up study, 326 adult patients who initiated biologic therapy for severe uncontrolled CRSwNP were included.
Rhinology
December 2024
Otorhinolaryngology, Catholic University of Leuven, and Upper Airways Research Laboratory, University of Ghent, Belgium.
Chronic rhinosinusitis with nasal polyps (CRSwNP) often co-exists with asthma and non-steroidal anti-inflammatory drug- exacerbated respiratory disease (N-ERD), creating a more severe phenotype and an additional burden compared with CRSwNP disease alone (1-3). The relationship between these diseases in terms of shared immunological disbalance has been coined in the literature as 'global airway disease' or 'unified airway disease' and requires integrated treatment strategies (4-6). Our post hoc analysis of the Phase III randomised, double-blind, placebo-controlled, multicentre SYNAPSE study (GSK ID: 205687; NCT03085797 (7)) assessed the efficacy of mepolizumab, an anti-interleukin-5 monoclonal antibody, in simultaneously improving both CRSwNP and asthma outcomes versus placebo.
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