Treatment of nasal polyps with steroids

 
Normal Nasal Mucosa and Ostea of Maxillary Sinus : Click on pictures to enlarge !!!    
Foreign Body in the Nose:   This picture shows a plastic "hot wheels" toy in the right naris of a 5 year old.  The foreign body is wedged below the middle turbinate .  Attempts at removal in the emergency room was unsuccessful and the child was taken to the operating room for removal. 




Click on pictures to enlarge !!!    
This picture shows a wood chip foreign body in the nose.  It is located under the middle turbinate , deep in the middle meatus .  It was removed in the doctor's office under local anesthesia. 
Click on pictures to enlarge !!!    
Epistaxis :  Search PubMed for Epistaxis This picture shows prominent anterior (up-front) septal vessels which will bleed easily.  This type of nose bleed ( epistaxis ) usually occurs in children.

In patients where the nasal polyps do not seem to respond to the above protocol (or if patient is refusing surgery), the addition of a very strong drug called Zyflo (zileuton) may be of benefit. This drug can cause liver damage (in <10% of patients) and as such, liver function bloodwork (AST/ALT) is required every month for 3 months and yearly thereafter. As long as the AST/ALT numbers do not exceed 150 (yes, it is higher than what is considered normal), it is generally considered safe to continue with this drug (though would check bloodwork weekly if that happens to ensure stability). Getting an immunologist involved in the care of such patients would also be beneficial, especially for those patients where the nasal polyps are particularly resistant to standard treatment.

Treatment of nasal polyps with steroids

treatment of nasal polyps with steroids

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