Journal
IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA
Volume 29, Issue 4, Pages 657-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.iac.2009.07.001
Keywords
Corticosteroids; Chronic rhinosinusitis; Nasal polyps; Endoscopic sinus surgery; Efficay and safety
Categories
Funding
- Schering-Plough
- Grupo Uriach SA
- UCB Pharchim
- MSD
- Generalitat de Catalunya
- Centro de Investigaciones Biomedicas en Red de Enfermedades Respiratorias (CIBERES)
- Global Allergy and Asthma European Network (GA2LEN)
- Centro de Desarrollo Estrategico e Informacion en Salud y Seguridad Social
- Caja Costaricense del Seguro Social (CENDEISSS, Costa Rica)
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Chronic rhinosinusitis, including nasal polyps, is an inflammatory disease of the nose and sinuses. The medical treatment, mainly topical intranasal and oral corticosteroids, constitutes its first line of therapy. Long-term treatment with corticosteroid nasal spray reduces inflammation and nasal polyp size, and improves nasal symptoms such as nasal blockage, rhinorrea, and the loss of smell. Corticosteroid intranasal drops may be used when intranasal spray fails to demonstrate efficacy. Short courses of oral steroids are recommended in severe chronic rhinosinusitis with nasal polyps or when a rapid symptomatic improvement is needed. Endoscopic sinus surgery is only recommended when the medical treatment fails. Intranasal corticosteroids should be continued postoperatively. When using intranasal corticosteroids, care should be taken in selected populations such as children, pregnant women, and elderly patients; especially in those patients with comorbid conditions such as asthma, in which the overall steroid intake can be high due to the administration of both intranasal and inhaled corticosteroids.
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