What role do intranasal corticosteroids play in the management of nasal polyps, and how should they be prescribed?

Role of intranasal corticosteroids in nasal polyps: Intranasal corticosteroids are used as a first-line treatment to reduce inflammation and nasal congestion associated with nasal polyps. They help to manage symptoms by decreasing polyp size and improving nasal airflow.

Recommended prescribing practices: Intranasal corticosteroids should be offered as initial treatment for nasal obstruction caused by nasal polyps. Treatment should be continued regularly to maintain symptom control. If symptoms persist despite initial treatment, referral to an ear, nose, and throat (ENT) specialist should be considered, especially if anatomical obstruction is suspected.

Although the provided guideline excerpts focus primarily on rhinitis management in people with obstructive sleep apnoea and obesity hypoventilation syndrome, they recommend topical nasal corticosteroids for allergic and vasomotor rhinitis, which is consistent with their use in inflammatory nasal conditions such as nasal polyps. Persistent symptoms despite corticosteroid treatment warrant specialist referral ¹.