title: Intrapolyp steroid injection for nasal polyposis: Randomized trial of safety and efficacy.
abstract: Local and systemic steroid treatment is the mainstay of therapy for nasal polyposis. This study aims to evaluate the safety and effectiveness of intrapolyp steroid injection on nasal polyposis and to compare the outcomes with short-term oral steroid treatment.
  
  
  
  Prospective, randomized, controlled endoscopic clinical trial.
  
  
  
  Ninety patients with nasal polyps were randomly assigned in a 1:1 ratio to receive oral prednisolone 1 mg/kg/day, tapering by 5 mg/day, for 2 weeks, or to receive intrapolyp steroid injection (40 mg/mL triamcinolone, 1 mL) for up to five times with intervals of 1 week. Both groups received fluticasone propionate nasal drops twice daily for 12 weeks after initial treatment. Total nasal symptoms scores and total nasal polyp scores of both groups were evaluated before and 3 and 6 months after treatment, whereas computed tomography (CT) scores were evaluated before and 6 months after treatment. Also, plasma cortisol and adrenocorticotropic hormone (ACTH) levels of the patients in the intrapolyp steroid injection group were evaluated before, during, and after treatment.
  
  
  
  A total of 211 injections were given to 45 patients, and no serious complications were observed. Both groups showed significant decrease in symptom score, polyp score, and CT score (P > 0.001), with no significant difference between groups (P > 0.05). Plasma cortisol and ACTH levels of the injected patients were in normal limits before treatment, 1 week after the first injection, and 1 week after the last injection.
  
  
  
  Intrapolyp steroid injection appears to be an effective and safe method for treatment of nasal polyps, with comparable results to oral short-term steroid treatment.
  
  
  
  1b. Laryngoscope, 126:1730-1735, 2016.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Kırıs
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ataturk Education and Research Hospital, Ankara, Turkey.
authors.forename: Togay
authors.initials: T
authors.lastname: Muderris
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ataturk Education and Research Hospital, Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Yalçıner
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: Sami
authors.initials: S
authors.lastname: Bercin
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Karaman State Hospital, Karaman, Turkey.
authors.forename: Ergun
authors.initials: E
authors.lastname: Sevil
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Bitlis Tatvan State Hospital, Bitlis, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Gul
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000188:drug therapy*; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone; D011239:Prednisolone
keywords: Nasal polyposis; intrapolyp steroid injection; oral steroids; plasma ACTH level; plasma cortisol level; visual loss