First-line treatment for adults diagnosed with nasal polyps in primary care is the use of topical intranasal corticosteroids. These medications help reduce inflammation and polyp size, improving nasal airflow and symptoms.
Initial management typically involves prescribing a regular regimen of intranasal corticosteroid sprays, which are effective in controlling symptoms and may reduce the need for surgery.
In cases where allergic rhinitis coexists, antihistamines may be considered adjunctively, but corticosteroids remain the cornerstone of treatment.
Referral to an ear, nose, and throat (ENT) specialist should be considered if symptoms persist despite optimal medical therapy or if anatomical obstruction is suspected.
Emerging treatments such as biological therapies are being explored but are not currently first-line in primary care.
This approach aligns with UK clinical guidance on managing nasal obstruction and rhinitis, which recommends topical nasal corticosteroids as initial therapy for nasal polyps and related nasal inflammation NICE NG202. Evidence-based literature supports the efficacy of intranasal corticosteroids in reducing polyp size and symptom burden, emphasizing their role as the mainstay of treatment Bachert 2011. Expert opinion also highlights the potential for biological treatments in refractory cases but confirms corticosteroids as first-line Al-Ahmad et al. 2022.
Key References
- NG202 - Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s
- (Bachert, 2011): Evidence-based management of nasal polyposis by intranasal corticosteroids: from the cause to the clinic.
- (Al-Ahmad et al., 2022): Expert Opinion on Biological Treatment of Chronic Rhinosinusitis with Nasal Polyps in the Gulf Region.