Comparative Efficacy of Nasal Steroid in Combination With an Antihistamine Versus Steroid Alone as Nasal Spray in Nasal Polyposis

Abstract

Nasal polyposis is a disease entity characterized by development of benign growths arising either from the nasal mucosa or from any of the Para-nasal sinuses alone or in combination. These out growths are associated with oedema, fibrosis, reduced vascularization, decreased number of glands as well as nerve endings and damaged epithelium. The cause of nasal polyposis is not completely understood; however, it is frequently associated with asthma and intolerance to aspirin. The condition is characterized by eosinophil inflammation: approximately65% to 90% of polyps is classified histologically as eosinophilic. The symptoms of nasal polyposis include nasal obstruction, watery discharge and impairment of sense of smell. The objectives for the management of the condition include elimination or reduction in the size of polyps followed by reestablishment of an open nasal airway and nasal breathing, improvement or restoration of sense of smell and ultimately prevention of polyp recurrence. In nasal polyposis, topical nasal corticosteroids are considered the medical treatment of choice and several different intranasal corticosteroids in combination with antihistamines have been investigated with regard to both effect on symptoms and reduction in polyp size. These benefits maybe attributed at least in part, to the effect of topical corticosteroids on decreasing eosinophilic infiltration in the nasal mucosa. The objective of the present study is to evaluate the comparative efficacy of local nasal steroids alone and in combination with an antihistamine. KEYWORDS: Polyposis, Fluticasone, Azelastine, Nasal spray, Rhinorrhoea, metered dosage, MATERIALS AND METHODS:The present study is a prospective study to evaluate the role of steroids in combination with Antihistamine in the form of nasal spray used in selective patients suffering from Nasal polyposis prior to surgical procedure. Comparative efficacy of steroid nasal spray versus combination of steroid with antihistamine nasal spray in nasal polyposis is also evaluated. The present Study includes 60 patients with Nasal polyposis in nose and Para-nasal sinuses treated in the department of ENT, Government General Hospital attached to Kurnool Medical College, Kurnool.This Study was conducted for a period of 2 years from June 2010-November 2012. This study is a prospective, comparative, study. 60 patients are selected for this study among 7054 patients who attended the Outpatient department with complaints related to nose and Para-nasal diseases constituting to 0.85%. All the patients are subjected to detailed history taking, clinical examination, endoscopic examination, radiological investigation, counseling for pre-operative medical management and regular follow-up. The Data was collected in a standard format for calculation and ready reckoning. DNE and endoscopic grading of polyps is done. Patients are given a simple DOI: 10.14260/jemds/2014DOI: 10.14260/jemds/ /2942 Page 7596 questionnaire relating to symptoms in order to grade the severity of complaints which are ...