Topical steroids such as betamethasone drops are effective in over 80% of patients with simple nasal polyps (1). Systemic absorption is minimal and there are few side effects. The steroids are best administered initially in drop form with the patient bent forward adopting the "mecca" position to administer them. This ensures that the drops reach the ethmoid air cells.
If there is concern over possible systemic effects of betamethasone then treatment can be changed after about six weeks to one of the topical steroids not systemically absorbed e.g. beclamethasone (1).
In severe cases of nasal polyposis, systemic steroids may be used in short reducing doses.
Topical steroids may also be used post-operatively, to reduce recurrence.
Ref: The Practitioner (1997), 241, 620.
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