Fast Five Quiz: Nasal Polyps Nonsurgical Management

Arlen D. Meyers, MD, MBA


December 08, 2020

Antifungal agents do not play a role in the management of nasal polyposis, although they may be useful in cases of allergic fungal sinusitis with polyposis.

Data suggest that monoclonal antibodies, such as dupilumab and omalizumab, can be effective for the management of nasal polyps. In the phase 3 LIBERTY NP SINUS-24 and SINUS-52 trials, the addition of the monoclonal antibody dupilumab to standard-of-care mometasone furoate nasal spray significantly improved nasal congestion and obstruction, nasal polyp score, sinus opacification, and sense of smell in patients with severe recurrent nasal polyps.

Although more studies are needed, intrapolyp steroid injections may be a safe alternative to surgery for some patients, because they have been shown to reduce polyp growth and nasal symptom scores compared with intranasal medical therapy. A retrospective chart review and literature analysis showed a small likelihood of visual complications after steroid injections for nasal polyps. For example, in a review of nine case series comprising 117,669 intranasal steroid injections, only three (0.003%) resulted in visual complications, which were transient and resolved spontaneously.

Clinical evidence suggests that bioabsorbable, steroid-eluting sinus implants may be a promising new intervention after surgical intervention for safely reducing polyp size as well as symptom burden.

Learn more about the medical management of nasal polyps.


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