Histologically, the presence of a large quantity of extracellular fluid, mast cell degranulation and eosinophilia has been demonstrated for occurrence of nasal polyps. Typically the patients show nasal obstruction, anosmia and rhinorrhoea. A population-based random sample (4300) of adult women and men aged 18-65 years served by the Paijat-Home Central Hospital in southern Finland (a region with 208 000 inhabitants) was performed.
Corticosteroids are the treatment of choice, either topically or systemically. Direct injection into the polyp is not approved by the US Food and Drug Administration (FDA) because of reports of unilateral vision loss in 3 patients after intranasal steroid injection with Kenalog. Studies should be performed to compare nasal steroids as a single modality of treatment with antibiotics in patients with intermittent or persistent rhinosinusitis. To provide good evidence for the use of local antibiotic treatment in acute exacerbations of chronic rhinosinusitis, further studies with better characterized patients are needed.