engleski

Impact of short term topical capsaicin or furosemide vs. oral steroid treatment in nasal polyposis

Long term topical furosemide or capsaicin treatment offer better nasal polyp recurrence protection than placebo. The aim of the study was to compare the outcomes of a short term topical capsaicin and furosemide with oral steroid treatment in terms of nasal symptom scores, polyp size, inflammatory cells and oedema reduction. Material & Method Forty nasal polyp patients were randomly allocated to 7-day treatment with either oral methyprednisolon (1mg/kg/day) or nasal furosemide (20 mg/day), while 16 patients with massive polyposis received topical capsaicin (30-100 mmol solution) in 5 consecutive days. Nasal symptoms and polyp scores followed by a biopsy of the most superficial polyp were done before and after the treatment. Eosinophils and mastocytes were counted and scored in 10 high power fields (400x) per slice throughout the specimen and edema was measured. Results: Subjective and endoscopy scores did not differ significantly between the furosemide and steroid groups, but endoscopy scores was significantly higher in capsaicin group before and after the treatment. All subjective and endoscopy scores were significantly improved after the treatment in all groups. There was no significant difference in subjective scores between the groups before the treatment and after the treatment, except for olfaction, which was better improved in steroid than capsaicin, but not than in furosemide group. However, reduction of endoscopy scores before and after the treatment was not different between the groups. Steroid significantly reduced eosinophils, with no effect on mastocytes and edema. Furosemide and capsaicin had no effect on inflammatory cells, but furosemide reduced oedema. Conclusions: Topical capsaicin and furosemide 7-day treatment have significant impact on nasal symptoms and polyp size reduction, which is comparable to the effect of oral steroid. Steroid treatment significantly reduced eosinophil infiltration, while no effect on inflammatory cells was demonstrated for furosemide and capsaicin.

nasal polyps ; furosemide ; capsaicin ; controlled trial ; steroid

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