Medical and surgical management of nasal polyps

Sinonasal polyposis represents a chronic inflammatory condition of unknown etiology. It is often associated with systemic diseases and is characterized by nasal obstruction, reduction in sense of smell, infection, and impaired quality of life. Endoscopy has enhanced the diagnosis and management of nasal polyps. The initial approach is medical management. Medical therapy consists of administration of intranasal steroids or a short course of systemic steroids. Other medical treatments considered are use of antibiotics, leukotriene modifiers, and acetylsalicylic acid avoidance. Surgical removal is performed for nonresponders to medical management. The purpose of surgery is to restore the nasal physiology by making the nose free from nasal polyps and allowing drainage of infected sinuses. With a computer-assisted navigation system and power instrumentation, surgical removal of polyps can be done more easily and accurately with fewer complications than previously. Medical therapy after surgery is essential for preventing recurrence.