Benign nasal polyps are bags of watery tissue arising from the lining (mucosa) of the nasal cavity or the nasal sinuses that protrude into the nasal passages, often on both sides of the nose. The symptoms are nasal obstruction, poor sinus drainage, loss of smell that affects a person's ability to taste, runny nose or nasal congestion. These can be troublesome or limit daily activities and ability to sleep so that well-being and quality of life are reduced. Nasal polyps can be removed surgically or treated with steroid medication, given by nasal sprays or drops (topically) or by mouth (orally). Treatment is either aimed at treating the initial problem or is aimed at preventing recurrence of polyps. No single surgical technique has proved entirely curative and people often undergo repeat procedures. Oral steroids may reduce the need for surgery but there are concerns about possible side effects with long-term oral steroid use. The side effects of short courses of oral steroids are less clearly defined.
We found three trials, with a total of 166 patients, that met the inclusion criteria for the review. In these trials the 96 patients who were randomised to receive oral prednisone showed an improvement in quality of life and nasal symptom scores and a significant reduction in polyp size after two to four weeks of treatment compared to no steroid treatment. However, the trials were of moderate to low methodological quality.