Effects of oral prednisolone and fluticasone nasal spray in the management of chronic rhinosinusitis with polyposis: A prospective observational study

Abstract

To study the effects of combination therapy with oral prednisolone and topical fluticasone propionate nasal spray in patients with Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP). To study the improvement in symptom scores, Endoscopic and CT scores before and after treatment with combination therapy.This prospective observational study was conducted on 50 patients attending the Outpatient Department of Otorhinolaryngology, J.L.N Hospital and Research Centre, Bhilai (Chhattisgarh), India over a period of 6 months from February 2020 to July 2020. Patients with symptoms of CRSwNP persisting for more than 12 weeks were thoroughly examined clinically along with Nasal endoscopy and Computed Tomography scan of Nose and Paranasal sinuses (CT PNS) and pre-treatment Visual Analog Scale (VAS), Lund & Mackay Scores for Endoscopic and CT findings were noted. Patients were treated with combination therapy of oral prednisolone and fluticasone propionate nasal spray and post treatment scores were noted using similar scales during the follow up visits and the results were statistically analysed.Total mean age of patients suffering from CRSwNP in our study was 47.3 ± 12.58. Males were affected more by CRSwNP than females (76% vs 24%). At the end of 3 months from baseline 48 patients (96%) showed a reduction in nasal discharge, 47 patients (94%) showed a reduction in nasal obstruction, 25 patients (50%) showed improvement in facial pain and 17 patients (34%) showed improvement in hyposmia. Overall post treatment Visual Analog Symptom (VAS) score improved in 42 patients (84%), Nasal endoscopy (Lund - Mackay scoring) improved in 43 patients (86%) and Radiological CT PNS & Nose (Lund - Mackay Scoring) improved in 33 patients (66%).We found that combined therapy with oral prednisolone and fluticasone propionate nasal spray for 3 weeks is very effective in reducing the symptoms of chronic rhinosinusitis along with decrease in nasal secretions, edema and polyp size.