Unitat de Rinologia & Clínica de l'Olfacte, Department of Otorhinolaryngology, Hospital Clínic, c/Villarroel, 170 Barcelona 08036, Catalonia, Spain.
Immunol Allergy Clin North Am. 2009 Nov;29(4):657-68. doi: 10.1016/j.iac.2009.07.001.
Chronic rhinosinusitis, including nasal polyps, is an inflammatory disease of the nose and sinuses. The medical treatment, mainly topical intranasal and oral corticosteroids, constitutes its first line of therapy. Long-term treatment with corticosteroid nasal spray reduces inflammation and nasal polyp size, and improves nasal symptoms such as nasal blockage, rhinorrea, and the loss of smell. Corticosteroid intranasal drops may be used when intranasal spray fails to demonstrate efficacy. Short courses of oral steroids are recommended in severe chronic rhinosinusitis with nasal polyps or when a rapid symptomatic improvement is needed. Endoscopic sinus surgery is only recommended when the medical treatment fails. Intranasal corticosteroids should be continued postoperatively. When using intranasal corticosteroids, care should be taken in selected populations such as children, pregnant women, and elderly patients; especially in those patients with comorbid conditions such as asthma, in which the overall steroid intake can be high due to the administration of both intranasal and inhaled corticosteroids.
慢性鼻-鼻窦炎（包括鼻息肉）是一种鼻和鼻窦的炎症性疾病。医学治疗主要是局部鼻腔和口服皮质类固醇，构成其一线治疗方法。长期使用皮质类固醇鼻腔喷雾剂可减轻炎症和鼻息肉的大小，并改善鼻塞、流涕和嗅觉丧失等鼻部症状。当鼻腔喷雾未能显示疗效时，可以使用皮质类固醇鼻腔滴剂。对于伴有鼻息肉的严重慢性鼻-鼻窦炎或需要快速缓解症状的患者，建议短期口服类固醇。仅当药物治疗失败时才推荐进行内镜鼻窦手术。手术后应继续使用鼻腔皮质类固醇。在使用鼻腔皮质类固醇时，应注意一些特定人群，如儿童、孕妇和老年患者；特别是在那些患有哮喘等合并症的患者中，由于同时使用鼻腔和吸入皮质类固醇，总体类固醇摄入量可能会很高。
