From the Guidelines
Treatment for nasal mucous retention cysts or polyps should begin with conservative approaches, including nasal corticosteroid sprays and saline nasal irrigation, before considering surgical intervention, as recommended by the most recent and highest quality study 1. The initial treatment often includes nasal corticosteroid sprays such as fluticasone (Flonase) or mometasone (Nasonex), used once or twice daily for several weeks to reduce inflammation and shrink the polyps.
- Saline nasal irrigation with devices like a neti pot or squeeze bottle, performed 1-2 times daily with sterile saline solution, helps clear mucus and reduce irritation.
- For more severe cases, oral corticosteroids like prednisone (typically 20-40mg daily for 5-7 days) may be prescribed to rapidly reduce polyp size, as supported by studies 1.
- Antibiotics are only indicated if there's evidence of bacterial infection. If conservative treatments fail, surgical options include endoscopic sinus surgery to remove polyps or marsupialization (creating an opening) for mucous retention cysts.
- Surgery is performed under local or general anesthesia as an outpatient procedure. These treatments work by reducing inflammation, improving drainage, and removing obstructive tissue.
- Most patients require ongoing maintenance therapy with nasal steroids after treatment to prevent recurrence, as nasal polyps tend to return in many cases, highlighting the importance of long-term management 1.
From the FDA Drug Label
What if I’m having severe sinus pain If you feel severe pain in your face, have thick nasal discharge, or think you may have a sinus infection, stop using Fluticasone Propionate Nasal Spray, USP and see your doctor. Your doctor may want to consider if other medicines are needed.
The treatment for nasal mucous retention cyst or polyps is not directly addressed in the provided drug label for Fluticasone Propionate Nasal Spray, USP 2. However, it does mention that if you have severe sinus pain, thick nasal discharge, or think you may have a sinus infection, you should stop using the spray and see your doctor, as they may consider other medicines.
- Key points:
- The drug label does not provide direct information on treating nasal mucous retention cyst or polyps.
- It advises stopping the use of Fluticasone Propionate Nasal Spray, USP and consulting a doctor if severe sinus pain or suspected sinus infection occurs.
- The label suggests that the doctor may consider other medicines in such cases.
From the Research
Treatment Options for Nasal Mucous Retention Cyst or Polyps
- Topical corticosteroids are the medical treatment of choice for nasal polyps, aiming to eliminate or reduce polyp size, re-establish nasal airway and breathing, improve or restore the sense of smell, and prevent recurrence 3.
- The efficacy of topical corticosteroids, such as betamethasone sodium phosphate nose drops, beclomethasone dipropionate, fluticasone propionate, and budesonide nasal sprays, has been demonstrated in several randomized, placebo-controlled trials 3, 4.
- Fluticasone propionate nasal drops have been shown to be effective in reducing polyp size and rhinitis symptoms, and in delaying the recurrence of polyps after surgery 4, 5.
Specific Treatment Regimens
- Fluticasone propionate nasal drops 400 microg once or twice daily have been found to be effective and well-tolerated in the treatment of bilateral nasal polyposis 4.
- Treatment with fluticasone propionate nasal drops can reduce the need for surgery in patients with severe nasal polyposis and chronic rhinosinusitis 5.
- The fluticasone exhalation delivery system has been shown to improve outcomes in patients with chronic rhinosinusitis with nasal polyps, including significant improvements in quality of life, smell, and endoscopic assessment of polyp grade 6.
Current State of Medical Management
- Intranasal saline irrigations and topical steroids are mainstays of treatment for chronic rhinosinusitis with nasal polyposis, with a focus on reducing inflammation and limiting polyp recurrence 7.
- Alternative steroid delivery methods and adjunctive treatments, such as antibiotics and anti-leukotrienes, may be beneficial for certain patient populations, but more evidence is needed to support their use 7.