The role of intranasal steroid therapy in the treatment of chronic sinusitis with nasal polyps

Abstract

Polypoid rhinosinusitis (PRS) is a form of chronic rhinosinusitis (CRS), which is a heterogeneous group of pathological conditions based on a chronic inflammatory process of the nasal cavity and paranasal sinuses (PNS), leading to polypoid tissue formation. In most cases, T2-inflammation underlies the pathogenetic mechanism of PRS. In the presence of T2-associated conditions, the course of PRS is usually severe. The main aim of PRS treatment is to control symptoms, prolong the recurrence-free period, and restore the aeration of the PNS. The basic therapy of PRS involves the use of intranasal glucocorticosteroids (InGCS), which have a nonspecific anti-inflammatory effect by acting on different points of the pathological inflammatory process. The level of evidence for the use of InGCS is Ia: the drugs are included in Russian and foreign clinical guidelines for the treatment of polypoid rhinosinusitis. InGCS have high topical activity at low steroid doses. Mometasone furoate has an important place among this group of drugs because of its high efficacy, long-lasting therapeutic effect and optimal safety profile. The drug is officially registered for the treatment of PRS. Long-term use of mometazone furoate has been clinically observed to cause almost no atrophic nasal mucosal changes. It can be administered as monotherapy and in combination therapy over long periods of time in all phases of the treatment of PRS.