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New Treatment Options for Nasal Polyps

Πολύποδες της μύτηςWhat are nasal polyps?

Chronic inflammation in the nose, can lead to topical swellings of the internal lining, which are called polyps. Polyps can originate from the nasal cavity or the internal of the sinuses, which communicate with the nose via narrow openings, called ostia. It is a chronic condition of the nose, with main symptoms nasal obstruction and smell disorders, but also sneezing, nasal discharge and cough. Often it is complicated with infections in the sinuses, due to obstruction of the ostia (sinusitis). 

How they are treated

Initially, polyps are treated with topical steroid sprays. When the result is not satisfactory, surgery may be needed, aiming at: 

  • Removal of all polyps in the nose and sinuses. 
  • Widening of the sinus ostia, in order to make them accessible to topical treatment, usually delivered by means of washouts with steroid solutions. 

With the combination of appropriate endoscopic surgery and topical therapy, a significant percentage of the patients do well, provided they are followed up regularly and they repeat treatment, as necessary.

The “difficult” patients 

Although with this management more than 85% of the polyp patients are expected to do well in the long term, there are still some patients who fail to respond, and their polyps tend to reappear after treatment. Today we know that this treatment failure is not a real recurrence, but reflects our inability to sufficiently control their disease.  

Steroids by mouth in regimens of 20-30 days have good but transient effect, and cannot be repeated more than 1-2 times per year, due to possible adverse effects resulting from frequent use of the drug. 

Monoclonal Antibodies 

For these patients, we now have a new therapeutic option. Special biologic agents or monoclonal antibodies block the inflammation cascade at various levels and control the disease. 

Athens Rhinology Team was the first ENT unit in Greece that started using these drugs in 2021, and we already have more than 22 patients on treatment and follow-up. All of these patients have had more than 2 surgeries in the past and numerous steroid regimens, with no satisfactory control of their disease. Soon after they started the biologic treatment, their symptoms subsided, they feel well and their asthma also improved, when present. 

If you suffer from severe nasal polyposis, maybe this treatment is appropriate for you.
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