Medical Management of Chronic Rhinosinusitis with Nasal Polyposis

Publication Date: November 9, 2022
Last Updated: May 1, 2023

Summary of Recommendations

In people with chronic rhinosinusitis with nasal polyposis, the guideline panel suggests intranasal corticosteroid rather than no intranasal corticosteroid. (C, L)
Additional considerations:
  • The network meta-analysis linked to this guideline showed that delivery method of INCS was potentially important. INCS stent, spray, and exhalation delivery system (EDS) are among the most beneficial of the INCS delivery methods across multiple patient-important outcomes.
  • The costs, availability, accessibility, and practical implications of the different methods of INCS delivery are likely to influence patient decision making.
  • There is moderate certainty of evidence for the safety of INCS spray but safety may vary among the other delivery options. There is low or very low certainty in the safety of INCS using delivery methods other than spray.
  • INCS have small treatment effect sizes. Patients with severe or rapidly recurrent disease may value more treatments with larger reductions in symptoms.
  • There is probably uncertainty in the value and importance patients put on the outcomes that patients consider critical to decision making.
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Medical Management of Chronic Rhinosinusitis with Nasal Polyposis

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