Utilization of Corticosteroid Delivery Systems for Treatment of Nasal Polyposis - Episode 11

Use of Steroids After Surgery in Nasal Polyposis

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Drs Anju Peters and Naveen Bhandarkar comment on the use of steroids after surgery for nasal polyposis.

Anju Peters, MD: Thank you both for sharing. Let's go on to you Naveen. What do you see? What treatment options exist for patients whose symptoms recur after surgery? Is there a role for EDS-FLU, if any, in these patients? And if you would focus on the study from 2022, that would be wonderful.

Naveen Bhandarkar, MD: There's certainly a role for any topical steroid after surgery, because again, we're talking about an inflammatory disease state, a chronic inflammatory disease state. And in my mind the question of steroid after surgery is a matter of what, not if and we've seen in multiple studies that polyp in particular recurrence rates are quite high at a certain number of months after sinus surgery. I focus on keeping people on topical steroid as early as possible after sinus surgery. And you mentioned what the role of EDS fluticasone might be, and it has a key role in treatment of these patients afterwards. One of the precautions that we need to pay attention to with exhaled delivery steroid is when to potentially restart it after surgery, because one of the package insert precautions is recommending against use in the setting of recent trauma which includes surgery. In my practice that usually looks like about 2 weeks at the point where mucosal healing has occurred. Certainly, we can consider other forms of topical steroid and fairness, even topical steroid sprays still remain an option. Drew had a nice summary earlier of topical steroid irrigations and then we had already the possible role of implants, but, yes, exhalation delivery steroid does play a key role, and that would be supported by the data in all these studies that we've been talking about so far.

Transcript edited for clarity