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nasal polyposis

Question
My 15-year-old son presents a worsening of his polyposis. He's treated by rh-DNAse via mask for his chronic sinusitis, tobramycin inhalation and colimycine inhalation in alternation one every 2 months because of a chronic colonization of Pseudomonas and azithromycin and nasal cortisone spray.
Since this summer he is very embarrassed by an obstruction of the left nostril which seems to be due to a polyp and this in spite of the increase of the nasal cortisone spray (4 times per day). He has a cure of cortancyl® [prednisone] (1mg / kg / day during 7 days) which made decrease the polyp, but since stopping the cortancyl®, the sensation of nasal obstruction reappears.
Is there only the surgery to overcome this polyp? And how long?
Answer
Hello,

Some patients are actually very embarrassed by a nasal obstruction due to polyps in spite of an optimal medical treatment like it seems to be the case for your son.

The surgical indication can be discussed but the efficiency is most of the time passing without we can predict the duration of the felt clinical improvement.

A Metaanalysis in 2012 (Rhinology. 2012 Dec;50(4):360-9 doi: 10.4193/Rhino11.271. Macdonald KI) investigated 586 operated patients; they did not mention unwanted effects of the surgery and a constant clinical improvement. The studies are contradictory concerning a respiratory functional improvement or the number of days of hospitalization or necessary intravenous cures after surgery.

Good luck,
Cordially
Dr Isabelle Danner-Boucher
25.11.2014