Evaluation of efficacy of topical corticosteroid for the clinical treatment of nasal polyposis: searching for clinical events that may predict response to treatment.

The objective of the present study was to evaluate the clinical response to topical budesonide in patients with nasal polyposis (NP) and to evaluate if there is any clinical event that may predict the response to treatment. Twenty patients with NP were assessed by a clinical questionnaire, nasal endoscopy and sinusal computed tomography. The patients were then medicated with budesonide, 256 microg/nostril/day, for a 2-month period and afterwards they were submitted to a new clinical questionnaire and a new endoscopy. Post-treatment endoscopy revealed a significant reduction of polyp size's score (4.25 vs. 2.90, p < 0.01), which was associated to improvement of nasal symptoms: posterior rhinorrhea, headache, hyposmia, anterior rhinorrhea, and sneezing (p < 0.05). There was also a significant improvement of the sum of scores (20.10 vs. 10.30, p < 0.0001). Cacosmia and nasal itching did not respond to medical treatment. Patients with a higher tomographic extension of the polyp presented a significantly worse clinical response (p < 0.05). We conclude that there was partial, but significant, improvement of nasal symptoms and polyp size after treatment with nasal budesonide and that this clinical improvement was inversely correlated to the tomographic extension of NP at diagnosis.