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Chronic rhinosinusitis with nasal polyps Chronic rhinosinusitis with nasal polyps
Chronic rhinosinusitis with nasal polyps Chronic rhinosinusitis with nasal polyps

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Intrapolyp steroid injections, notably with Budesonide, present a promising approach for nasal polyposis management, demonstrating minimal side effects when compared to systemic steroids.

Implementing intrapolyp steroid injections proves to be a secure and efficient approach to managing nasal polyposis, with minimal side effects when contrasted with systemic steroids. The utilization of Budesonide as the chosen agent for intrapolyp injection shows promise as a strategic method, as deciphered from a study published in "The Laryngoscope". This research sought to explore usefulness of Budesonide as an intrapolyp injection in type 2 chronic rhinosinusitis with nasal polyps (CRSwNP) when compared to both systemic steroids and control group.

This prospective, double-blinded, controlled, randomized clinical trial included 150 patients diagnosed with CRSwNP which were allocated to groups A, B, and C in a 1:1:1 ratio. Group A received 1 mg/kg oral Prednisolone tapered daily for 2 weeks. Group B underwent Budesonide intrapolyp injections weekly for 5 consecutive weeks. Group C, the control, received intrapolyp injections with saline. Evaluations, including serum IgE, Total Nasal Polyp score (TNPS), Sinonasal Outcome Test (SNOT-22) score, absolute eosinophilic count, and morning cortisol levels, were conducted before therapy, at 1 week, and 6 months post-treatment.

There was a remarkable improvement in SNOT 22 scores across all groups compared to the baseline. The reduction in both oral and injection groups surpassed that of the control group (P2 < 0.001, P3 < 0.001), and a similar trend was observed for TNPS scores (P2 < 0.001, P3 < 0.001), with no noteworthy change in the control group. 

Hence, intrapolyp steroid injection, particularly Budesonide, proves safe and effective in nasal polyposis with minimal side effects compared to systemic steroids, showing promising outcomes.

The approach is particularly recommended for those experiencing frequent relapses or those at high risk to minimize the requirement for repeated oral steroid courses.

Source:

The Laryngoscope

Article:

The Efficacy of Budesonide as Intrapolyp Injection Agent in the Management of Type 2 CRSwNP

Authors:

Saad Elzayat et al.

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