The Efficacy of Double-Dose Mometasone Furoate Nasal Spray in Postoperative Management of Nasal Polyps: A Randomized Controlled Trial

Abstract

Background: Nasal polyps are benign growths of nasal mucosa associated with inflammation and topical nasal corticosteroids are the medical treatment of choice. Surgical removal is indicated for patients not responding adequately to medical treatment. There is little evidence on the efficacy of double-dose mometasone furoate nasal spray and conventional dose to prevent the recurrence of nasal polyps and decrease nasal symptom score following endoscopic sinus surgery. Objective: To compare the efficacy of double-dose mometasone furoate and conventional dose to prevent the recurrence of postoperative nasal polyps. Materials and Methods: The present study was a randomized controlled trial. Thirty patients who met the inclusion criteria were randomly divided into two groups, 15 patients in each group. Group I patients were given mometasone furoate two sprays in each nostril twice a day (400 μg) and Group II received mometasone furoate two sprays in each nostril once a day (200 μg) as a conventional dose for six months. Grading of nasal polyps and nasal symptom score were recorded before and after treatment at the first, second, fourth, twelfth and twenty-four weeks. Results: After six months of the endoscopic sinus surgery, Meltzer clinical scoring system of nasal polyps showed an average score of 0.67±0.72 in the conventional dose, which was significantly reduced to 0.07±0.26 (p<0.01) in the double dose of mometasone furoate. The average nasal symptom score in the conventional dose was 0.70±0.70, which was not significantly decreased to 0.30±0.50 (p=0.25) in the double dose. There were no side effects in both groups. Conclusion: Double-dose of mometasone furoate nasal spray might be recommended for preventing the recurrence of nasal polyps and decreasing nasal symptom score following surgery. Keywords: Nasal polyps; Intranasal corticosteroid; Endoscopic sinus surgery; Mometasone furoate; Recurrent nasal polyps; Nasal spray; Nasal symptom score; Randomized controlled trial; Postoperative management