Lildholdt T
Dept. of O.R.L., Vejle Hospital, Denmark.
Rhinol Suppl. 1989;8:31-3.
Surgical removal of nasal polyps is associated with discomfort and risks for the patient, but is the treatment of choice to most otorhinolaryngologists. Medical treatment alone has been little investigated. In a prospective clinical trial surgical removal followed by continuous topical steroid treatment has been compared with a single dose of steroid deposit followed by continuous topical steroid treatment. During a study period of one year, expiratory nasal peak flow and sense of smell were monitored. In general, the course in the two groups was alike, with a tendency favouring the medically treated group. In another study the clinical efficacy of this medical regimen was further documented experimentally. By acoustic rhinometry the square area of the nasal passages was measured before and a few days after the injection of the steroid deposit. Increased volume was found, corresponding to the instant clinical improvement. It is concluded that primary treatment of nasal polyps should be medical. Surgery is only recommended in cases, resistant to medical therapy.
鼻息肉的手术切除会给患者带来不适和风险，但对大多数耳鼻喉科医生来说仍是首选治疗方法。单独的药物治疗很少被研究。在一项前瞻性临床试验中，将手术切除后持续局部使用类固醇治疗与单次注射类固醇后持续局部使用类固醇治疗进行了比较。在一年的研究期间，监测了呼气鼻峰流量和嗅觉。总体而言，两组的病程相似，有倾向于药物治疗组的趋势。在另一项研究中，通过实验进一步证明了这种药物治疗方案的临床疗效。通过声反射鼻测量法，在注射类固醇前后几天测量鼻腔的方形面积。发现体积增加，这与即时的临床改善相对应。得出的结论是，鼻息肉的初始治疗应采用药物治疗。仅在对药物治疗有抵抗的情况下才建议手术。
