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Original Research

RMJ. 2012; 37(3): 309-312


Medical versus surgical treatment for early ethmoidal nasal polyps

Ashfaq Ahmed Malik, Fatima Usman, Ahmed Hasan Ashfaq, Naeema Ahmed.

Abstract
OBJECTIVE: To Compare the medical and surgical treatments for early bilateral ethmoidal nasal polyps.
SUBJECTS AND METHOD: sixty patients of grade I and II ethmoidal nasal polyps were selected through non-probability convenience sampling technique. They were divided in two groups; A & B with 30 patients in each group. In group A, patients were given medical treatment i.e. Tab prednisolone 0.5mg/kg/day for fourteen days in tapering doses along with two puffs of intranasal fluticasone in both nasal cavities equivalent to 50mcg/spray for three months while in group B, patients were treated surgically i.e. bilateral intranasal polypectomy with intranasal ethmoidectomy. The outcome of both methods was compared by evaluating the variables; reduction in size of polyps, nasal obstruction, sense of smell, postnasal drip and snoring.
RESULTS: Mean age of the patients was 34.11 9.48. Male to female ratio was 1.7:1. Out of total 60 patients, 23 patients were having grade I nasal polyps while 37 patients were having grade 2 nasal polyps. 17 grade 1 polyps were treated medically while 6 were treated surgically. Similarly 13 grade 2 polyps were treated medically and 24 were treated surgically. At the end of treatment, in Group A reduction in polyp size to grade 0 was seen in 66% of the patients while it was seen in 90% of the patients in group B. There was significant reduction in nasal obstruction, post nasal drip and snoring with surgical treatment however sense of smell showed significant improvement with medical treatment.
CONCLUSION: Surgical treatment for nasal polyps i.e. intranasal polypectomy with intranasal ethmoidectomy is better than medical treatment i.e. oral plus intranasal steroids in regard to reduction in size of polyps, nasal obstruction, post nasal drip and snoring. However loss of smell is better controlled with medical treatment.

Key words: Nasal polyps, prednisone, ethmoidectomy, fluticasone.



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