Comparison of the efficacy of nasal drop and nasal spray applications of fluticasone propionate in nasal polyps.

OBJECTIVES We assessed the efficacy of different forms of fluticasone propionate in the treatment of bilateral nasal polyposis in adult patients. PATIENTS AND METHODS This double-blind, randomized, parallel group study included 34 patients, aged 16 years or over, with a diagnosis of bilateral nasal polyposis. The patients were randomized to three groups to receive fluticasone propionate in the form of aqueous nasal spray 100 microg twice daily, or nasal drop preparation 400 microg once or twice daily for 12 weeks. Once every four weeks, nasal volumes were measured by acoustic rhinometry and polyp size was assessed by a 4-mm rigid endoscope. Clinical symptom scores were assessed once a week. RESULTS The mean nasal polyp scores decreased significantly in all the groups (p<0.005). Total nasal volume did not improve significantly with the nasal spray. Although single daily nasal drop application increased total nasal volume significantly only at the end of treatment (p<0.05), increases with twice daily application were significant at 4, 8, and 12 weeks, compared to the baseline values and corresponding values of the other two groups (p<0.005). Nasal blockage and rhinitis symptom scores improved in all the groups (p<0.05), but the difference from the baseline was highest with twice daily nasal drop application. Smelling showed a significant improvement only with twice daily nasal drop application (p<0.05). In none of the groups did nasal discomfort scores differ significantly from the baseline at the end of treatment. CONCLUSION Nasal drop preparation of fluticasone propionate given twice daily showed the highest efficacy in increasing total nasal volume, decreasing nasal polyp size, and improving smelling and nasal blockage.