Intralesional versus Systemic Corticosteroid Therapy for Nasal Polyps in Chronic Rhinosinusitis: Clinical Outcomes Study

Abstract

IPSI is defined as the local delivery of steroids directly into sinonasal polyposis in the management of diseases associated with CRSwNP. It should be noted that IPSI differs from systemic steroids treatment in terms of direct effect and lack of side effects due to administration of the drug. Here, we examine how IPSI and SC treatment differ in their effectiveness and efficacy when used in patients with CRSwNP. In total, 100 participants with a diagnosis of CRSwNP were enrolled in this prospective study and randomly assigned into two treatment groups. Healthy tackles to the polyps were added to IPSI every 2 weeks to 250 mcg/250 ml in sinus for 3 times in the first group and in the second group budesonide was injected directly into the polyps at 250 mcg/250 ml, once every 2 weeks for three times. The latter were given oral prednisolone at a rate of 1 mg/kg/day for three days, after which it was lowered to 5 mg/day for two weeks. Both the IPSI and SCs treatments had positive effects on the health status of the CRSwNP patients. Following SCs therapy, the nasal polyp volume decreased more (8.67 ± 2.6 vs. 10.15 ± 3.01, p < 0.001), the sense of smell improved (27.32 ± 10.68 vs. 23.32 ± 10.05, p < 0.001), and the SNOT-22 value decreased (36.32 ± 9.13 vs. 45.7 ± 12.66, p < 0.001).