Fast Five Quiz: Sinusitis With Nasal Polyps

Arlen D. Meyers, MD, MBA


June 18, 2021

Various approaches to medical therapy are available for the treatment of CRSwNP, with the chief goal of relieving the obstruction to sinus drainage by eradicating or reducing nasal polyps. However, when medical therapy fails to relieve the nasal obstruction, a surgical approach may be considered.

Therapy targeting the inflammatory mediators interleukin (IL)-4, IL-5, IL-13 and IgE are promising options for the treatment of refractory CRSwNP. As many as 40% of patients will experience polyp recurrence after surgery.

Oral steroid therapy followed by topical steroid therapy has been shown to be more efficacious than topical steroid therapy alone for reducing polyp size, enhancing olfaction, and improving symptom severity in patients with CRS with at least moderate nasal polyposis.

Leukotriene antagonists can serve as adjuncts to the steroids and may be particularly useful in patients with asthma and/or aspirin allergy. Treatment recommendations include systemic corticosteroids (3 weeks), a broad-spectrum antimicrobial agent active against Staphylococcus aureus (3 weeks), and/or a leukotriene antagonist.

For additional information, refer to the European Position Paper on Rhinosinusitis and Nasal Polyps 2020.

Learn more about treatment options for CRSwNP.

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