A randomized comparison of the usual surgical removal of nasal polyps versus systemic steroid treatment was performed in 53 patients. In all, continuous topical steroid treatment was given during the one year period of observation. In both groups the initial treatment resulted in a continuous increase in mean nasal expiratory peak flow as well as in the sense of smell; these two parameters showed a temporary statistically significant difference in favour of the medically treated group. In general though, the results in the two treatment groups were alike. Therefore medical treatment is recommended for routine use. Surgical removal should be reserved for those few cases in which the presence of residual or recurrent polyps justifies the inherent risks and discomfort for the patient.

The significant effect of topical ciprofloxacin is probably related to a higher local concentration of antibiotics in the middle ear rather than the result of mechanical rinsing and dissolution of the bacterial load.

A benign lipoblnstoma in the neck, causing respiratory insufficiency and ipsilateral ptosis and miosis, in a 9‐month‐old girl is reported, followed by a short discussion about the nomenclature, genesis, differential diagnosis and behavior of this rare condition.

Systemic steroids may remove symptoms from nasal polyps in most patients, while surgery only is necessary in a few resistant cases. However. topical medication is preferable. Sprays may prevent recurrencies, but they seldom suffice for removing polyps. The aim of the present study was to document clinical efficacy of steroid nose drops. In 24 patients with nasal polyps documented by mini biopsy, aqueous budesonide (Rhinocort Aqua. Draco. Sweden) was applied as nose drops. Every second day 0.25 ml was instilled in each nostril with the head down and forward. Conventional spraying was done twice daily. The clinical condition. nasal expiratory peakjlow, and sense (?(smell was monitored for at least two months. Thefrequency (?( applying drops was decreased if smell returned or polyps disappeared while spraying continued. Afew patients were not able to comply, and afew noticed insignificant nasal bleeding. In most cases the patients were satisfied after two or three months of treatment. It is concluded that in many patients nasal polyps can be managed by budesonide nose drops. However, the results of the present pilot study should be confirmed by controlled trials before routine clinical use is justified.

No abstract