What is the first line management for multiple small nasal polyps?

Intranasal corticosteroid spray is the preferred first-line management for multiple small nasal polyps. These medications are effective in reducing inflammation and the size of nasal polyps, ultimately improving nasal airflow and reducing symptoms such as nasal obstruction and congestion. Intranasal corticosteroids work locally to decrease the inflammatory processes that contribute to the development of polyps.

They are well-tolerated and have a favorable safety profile when used for extended periods, making them suitable for chronic conditions like nasal polyps. Regular use can lead to significant improvement in both the symptoms and size of the polyps, making this approach the most effective initial treatment.

Complementary treatments, such as saline nasal irrigation, can also be beneficial in managing nasal sinus diseases but typically serve as adjunct therapies rather than primary treatment options for polyps. While oral corticosteroids can be used for severe or refractory cases, they carry the risk of more significant systemic side effects and are not typically the first choice for small nasal polyps. Similarly, antihistamines may help with allergy-related symptoms but do not address the underlying inflammation responsible for polyp formation.