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Management of patients with sinonasal polyps ranges from systemic steroid to functional endoscopic sinus surgery; however, many patients refuse surgery or are contraindicated to receive systemic steroid. Intrapolyp steroid injection has been recently used to apply a higher concentration of steroids into the nasal polyps and on the other hand protecting the patient from the side effects of systemic steroid. In this study, we have tested intrapolyp steroid injection on 22 patients (injection group) and the results were statistically compared with the results of 16 patients treated by oral steroid (oral group) subjectively by total nasal symptoms score and objectively by total nasal polyp score and on CT films by using Lund Mackay scoring system, patients of both groups have been followed up for 3 months. After treatment, there was a statistically significant decrease in the score in both groups, with no significant difference in between them. No serious complications as visual disturbance apart from mild self-limited bleeding detected in only 2 injections (3%) of all 66 injections. Intrapolyp steroid injection is an effective, easy, and safe procedure with short-lasting effect for at least 3 months. It was proven to show comparable results to oral steroids as both modalities showed a statistically significant improvement subjectively and objectively. However, cases with extensive bulky polyposis were resistant to complete eradication by injection and they may need surgical intervention.

Comparative study between intrapolyp steroid injection and oral steroid for treatment of sinonasal polyposis in Egyptian patients