Abstract
Introduction Eosinophilic chronic rhinosinusitis (ECRS) is characterized by an eosinophilic inflammation
driven by Th2-type cytokines. Glucocorticosteroids are the most common first-line
treatment for ECRS with nasal polyps.
Objective We have evaluated the long-term treatment with double-dose intranasal corticosteroids
in refractory ECRS nasal polyps resistant to the conventional dose and assessed the
risk of adverse systemic effects
Methods Sixteen subjects were enrolled in this study. All subjects had ECRS after endoscopic
sinus surgery that resulted in recurrent mild and moderate nasal polyps and were undergoing
a postoperative follow-up application of mometasone furoate at a dose of 2 sprays
(100 μg) in each nostril once a day (200 μg). All the patients were prescribed mometasone
furoate, administered at a dose of 2 sprays (100 μg) in each nostril twice a day (400
μg) for 6 months.
Results The average scores of the symptoms during the regular dose of intranasal steroid
treatment were 5.2 ± 2.2, but 6 months after the high-dose application, they had significantly
decreased to 2.5 ± 1.4 (p < 0.05). The polyp size showed an average score of 1.38 during the regular dose which
was significantly reduced to 0.43 (p < 0.01) by the double dose. Glycated hemoglobin (HbA1c) showed normal ranges in all
the patients tested. The cortisol plasma concentration was also normal.
Conclusion Doubling the dose of the nasal topical spray mometasone furoate might be recommended
for the treatment of recurrent nasal polyps in the postoperative follow-up of intractable
ECRS.
Keywords
chronic rhinosinusitis nasal polyps - adverse effects - intranasal administration
- corticosteroids
