Survey of Local and Systemic Corticosteroids Use in Adults with Chronic Rhinosinusitis with Nasal Polyps in Chile.

INTRODUCTION: Local and systemic corticosteroids have long been the mainstay in the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), although there is no universally accepted prescription modality. A survey was conducted in Chile to determine the current prescription of topical and systemic corticosteroids in adult patients with CRSwNP. OBJECTIVE: To describe the use of local and systemic corticosteroids in adult patients with CRSwNP prescribed by otolaryngologists in Chile. MATERIAL AND METHOD: A cross-sectional study. A self-administered online survey was conducted among active members of the Chilean Society of Otorhinolaryngology, with 104 participating professionals. RESULTS: In CRSwNP, the most frequently prescribed topical corticosteroid was mometasone (69.2%) in the form of a daily intranasal spray. Nasal lavage is frequently indicated as an adjunctive treatment. The majority of respondents considered local adverse effects of local steroids to be minimal and systemic adverse effects to be infrequent. Prednisone is the most commonly used systemic corticosteroid (86.5%), especially in short bursts during exacerbations. However, there is heterogeneity in duration, dose, and route of administration. In surgery, systemic corticosteroids are used to optimize outcomes and reduce complications. CONCLUSION: The treatment of chronic rhinosinusitis with nasal polyps combines a medical and surgical approach. Topical corticosteroids are essential according to multiple international guidelines. The use of systemic corticosteroids should be rational, assessing risks and benefits. Given the heterogeneity of the results obtained in this study regarding steroid prescription, the development of clinical guidelines to standardize the rational use of topical and systemic corticosteroids in Chile should be considered.