A new staging system for nasal polyps. Influence of a combined local and systemic therapy with steroids.

Background: Nasal polyps are a common disease with in the majority of cases unknown origin. Both the medical and surgical treatment of nasal polyps pr esent a challenge in Otorhinolaryngology. Methods: We developed a four-stag e grading system for nasal polyps based on the endoscopic aspect of more th an 300 patients. In a study of 37 patients, treated by systemically (Methyl -prednisolon 64 mg p.o., decreasing amounts for the first 11 days) and loca lly (Budesonid 400 mu g intranasal) applied steroids for 90 days, this stag ing-system was tested. Results: The mean stage of polyps decreased signific antly (p < 0.01) from 2.8 at day 0 to 1.7 at day 7 and further to 1.2 and t o 0.7 at day 28 and day 90 respectively. The mean nasal symptom score decre ased equally from 1.14 on day 1 to 0.19 and to 0.14 on day 7 and day 28 res pectively. To summarize, we observed a significant (p < 0.01) decrease in p olyp stages of 75% respectively a significant (p < 0.01) reduction of sympt om scores of 93%. Conclusions: Thus, we present a suitable new grading syst em for nasal polyps which we applied directly to assess the efficacy of com bined local and systemic steroid therapy. It was shown that this treatment can reduce polyps and prevent their recurrence over the observed time.