***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Topical glucocorticoids are the medical treatment of choice in a majority of patients suffering from nasal polyposis .  Fluticasone propionate is a fluorinated steroid reported to be highly effective when used topically in the nose for seasonal and perennial allergic and nonallergic rhinitis . OBJECTIVES To evaluate the efficacy and tolerability of intranasal fluticasone propionate in the treatment of long-st and ing polyposis . METHODS Fifty-five patients with long-st and ing nasal polyposis were treated over a 26-week period with fluticasone propionate aqueous nasal spray 200 micrograms bid , beclomethasone dipropionate aqueous nasal spray 200 micrograms bid or placebo , administered intranasally in an aqueous spray in a double-blind , placebo-controlled parallel-group design at a single center . The primary efficacy endpoint was the physicians ' assessment of symptoms and polyp score . Peak nasal inspiratory flow was performed twice daily and on every visit to evaluate the effect of the corticosteroids on nasal air flow . RESULTS A significant difference in the primary efficacy endpoint between fluticasone propionate aqueous nasal spray and beclomethasone dipropionate aqueous nasal spray compared with placebo was seen after 14 weeks of treatment . This was further verified by the peak nasal inspiratory flow results . There was some evidence of earlier onset in the fluticasone propionate aqueous nasal spray group compared with the beclomethasone dipropionate aqueous nasal spray group after 4 weeks in terms of the primary efficacy endpoint . From the daily record cards patients receiving fluticasone propionate aqueous nasal spray had a significantly higher percentage of days on which they required no rescue medication ( P < .009 ) and a higher percentage of days with an overall nasal blockage score on waking of < 2 ( P < .013 ) when compared with placebo-treated patients . No other statistically significant results were found between the two active compounds . CONCLUSION Fluticasone propionate aqueous nasal spray 200 micrograms bid and beclomethasone dipropionate aqueous nasal spray 200 micrograms bid are effective in treating the symptoms of nasal polyps , with some evidence that fluticasone propionate aqueous nasal spray has a faster onset of action and is tolerated at least as well as beclomethasone dipropionate aqueous nasal spray at the same dose BACKGROUND : Topical nasal steroids such as beclomethasone dipropionate and fluticasone propionate have been widely used in the treatment of rhinitis and polyposis . An increase in infection has occurred with the use of fluticasone propionate after endoscopic polypectomy . OBJECTIVE : The purpose of this study was to determine the prevalence of nasal and paranasal infections with the use of topic nasal steroids after endoscopic polypectomy and to compare the recurrence rates of the polyposis . DESIGN AND SETTING : We conducted a prospect i ve , comparative , open , experimental , longitudinal study at an academic tertiary referral medical center . METHODS : One hundred sixty-two patients in whom endoscopic polypectomy had been indicated were r and omly divided into 3 groups of 54 patients each . The patients from the first group were treated with saline lavage only . Patients from the second group also received fluticasone propionate 400 μg/day in nasal spray after lavage . Patients from the third group received beclomethasone dipropionate 600 μg/day after lavage . The prevalence of infections and recurrence of polyposis was compared in the 3 groups . RESULTS : Three patients , 2 in the placebo group and 1 in the beclomethasone group , developed infections during the first 3 months after surgical procedure . The recurrence of polyps in the group without steroids was 44 % . In contrast , 15 % from the patients treated with fluticasone  showed recurrence of polyposis ; furthermore , 26 % of the patients treated with beclomethasone  showed recurrence of polypsosis , with a minimum follow-up of 12 months . CONCLUSIONS : The use of nasal steroids does not seem to increase the prevalence of infections after endoscopic polypectomy . ( Otolaryngol Head Neck Surg 2004;130:319–22 . BACKGROUND There is little scientific evidence to support the current practice of using oral glucocorticosteroids and antibiotics to treat patients with chronic rhinosinusitis and nasal polyps . OBJECTIVE We evaluated the effects of oral glucocorticoids and doxycycline on symptoms and objective clinical and biological parameters in patients with chronic rhinosinusitis and nasal polyps . METHODS In a double-blind , placebo-controlled , multicenter trial , we r and omly assigned 47 participants with bilateral nasal polyps to receive either methylprednisolone in decreasing doses ( 32 - 8 mg once daily ) , doxycycline ( 200 mg on the first day , followed by 100 mg once daily ) , or placebo for 20 days . Participants were followed for 12 weeks . Patients were assessed for nasal peak inspiratory flow and symptoms and by nasal endoscopy . Markers of inflammation such as eosinophilic cationic protein ( ECP ) , IL-5 , myeloperoxidase , matrix metalloproteinase 9 , and IgE were measured in nasal secretions . Concentrations of eosinophils , ECP , and soluble IL-5 receptor alpha were measured in peripheral blood sample s. RESULTS Methylprednisolone and doxycycline each significantly decreased nasal polyp size compared with placebo . The effect of methylprednisolone was maximal at week 3 and lasted until week 8 , whereas the effect of doxycycline was moderate but present for 12 weeks . Methylprednisolone significantly reduced levels of ECP , IL-5 , and IgE in nasal secretions , whereas doxycycline significantly reduced levels of myeloperoxidase , ECP , and matrix metalloproteinase 9 in nasal secretions . CONCLUSION This is the first double-blind , placebo-controlled study to show a significant effect of oral methylprednisolone and doxycycline on size of nasal polyps , nasal symptoms , and mucosal and systemic markers of inflammation This double-blind parallel-group study compared the effect of budesonide with placebo , in the prophylaxis of nasal polyp recurrence  after evulsion . Seventy-three patients with first time or recurrent polypectomy were enrolled . At revisits 3 and 6 months after evulsion , the budesonide-treated patients had significantly lower polyp scores than the placebo-treated patients . Only patients with recurrent nasal polyposis benefited from the budesonide treatment , whereas no effect was evident in patients with first time evulsion 60 patients , aged 15 - 51 years , with chronic allergic or bacterial maxillary sinusitis , were entered in a controlled , double-blind study comparing the efficacy of endonasal irrigations of tixocortol pivalate (Pivalone)-neomycin and neomycin . The treatment lasted 11 days and was administered once daily . A ventilometric measurement of sinus pressure was performed every two endonasal irrigations to assess treatment efficacy . The percentage of nasal deobstruction was significantly higher with tixocortol pivalate-neomycin than with neomycin alone by the fifth examination ( 9th day ) regardless of the etiology of the sinusitis ( allergic or bacterial ) . After 11 days of treatment , significantly better results were obtained in cases of bacterial sinusitis ( 94 % deobstruction with tixocortol pivalate-neomycin versus 74 % with neomycin ) than in cases of allergic sinusitis ( 69 % deobstruction with tixocortol pivalate-neomycin versus 36 % with neomycin ) OBJECTIVES To investigate the effect of intranasal corticosteroids in the treatment of polyps in patients with severe polyposis listed for surgical treatment and to determine the treatment effect on the progression of the disease . DESIGN A double-blind , r and omized , parallel-group , placebo-controlled , 12-week study at a single center . SETTING A tertiary referral center in London , Engl and . PATIENTS Thirty-four patients with severe polyposis listed for endoscopic surgical treatment . INTERVENTION By r and om allocation , fluticasone propionate aqueous nasal spray ( FPANS ) , 200 microg twice a day ; beclomethasone dipropionate aqueous nasal spray , 200 microg twice a day ; or placebo nasal spray twice a day was administered . Patients received 2 actuations to each nostril in the morning and in the evening . MAIN OUTCOME MEASURES Efficacy end points were the need for polypectomy at the end of treatment , the results of acoustic rhinometry , the polyp score , the peak nasal inspiratory flow rate , and an assessment of symptoms . RESULTS The polyp score was significantly decreased in the FPANS-treated group ( P < or = .01 ) . The nasal cavity volume was significantly increased in both the FPANS-treated group and the group receiving beclomethasone compared with placebo ( P < or = .01 ) at the end of treatment . The percentage change in the mean morning peak nasal inspiratory flow rate was greater in the FPANS-treated group , with a significant effect observed at week 2 ( P = .01 ) . Nasal blockage was significantly decreased in both active groups compared with the group receiving placebo . No significant difference was observed between the treatment groups in the number of patients requiring polypectomy . CONCLUSIONS Fluticasone and beclomethasone aqueous nasal sprays are effective in treating the symptoms of severe nasal polyps . There was some evidence that the group treated with FPANS responded more quickly to intervention and that the magnitude of the response was greater than in the group receiving beclomethasone Background The failure rate for frontal sinusotomy is higher than that of overall endoscopic sinus surgery ( ESS ) . To prevent frontal sinus obstruction , systemic or topical steroids are commonly used , but systemic steroid therapy can cause significant morbidity and topical sprays can not be distributed to the frontal ostium . This study was design ed to determine the efficacy of anatomically directed topical steroid drops in reducing frontal ostium stenosis compared with topical steroid sprays after ESS . Methods A prospect i ve , r and omized , single-blind study was conducted in 43 patients ( 77 nasal cavities ) who had undergone ESS , including frontal sinusotomy .  Twenty-one patients ( 39 nasal cavities ) used steroid drops applied with the Mygind technique , and 22 patient 8 nasal cavities ) used steroid sprays for 8 weeks postoperatively . The patency of the frontal ostium was evaluated endoscopically 3 months postoperatively . Results The study included 29 men and 14 women ( mean age , 48.2 years ; range , 19–62 years ) .  Endoscopic scores in terms of polypoid change , edema , and scar in the middle meatus and frontal recess were not significantly different between the groups , although the drop group showed a tendency to superior scores when compared with the spray group ( p > 0.05 ) . The frontal sinus patency of the drop group was significantly higher than of the spray group ( p < 0.05 ) . Conclusion Topical steroid drops using the Mygind technique led to a 16 % improvement in frontal sinus patency rates in 3 month after ESS in this study compared with postoperative topical steroid use OBJECTIVE To assess the efficacy and safety of fluticasone propionate administered using OptiNose 's novel delivery device ( Opt-FP ) in subjects with bilateral mild-to-moderate nasal polyposis . METHODS A prospect i ve , multicentre , r and omized , double-blind , placebo-controlled , parallel group study was conducted in adult subjects ( n = 109 ) with mild-to-moderate bilateral nasal polyposis . Subjects received Opt-FP 400 microg or placebo twice daily for 12 weeks . Endpoints included endoscopic assessment of polyp size using Lildholdt 's Scale , peak nasal inspiratory flow ( PNIF ) , symptom scores and use of rescue medication . RESULTS The proportion of subjects with improvement in summed polyp score > or= 1 ( Lildholdt\ 's Scale ) was significantly higher with Opt-FP compared with placebo at 4 , 8 and 12 weeks ( 22 % vs 7 % , p = 0.011 , 43 % vs 7 % , p < 0.001 , 57 % vs 9 % , p < 0.001 ) . After 12 weeks the summed polyp score was reduced by 35 % ( -0.98 vs + 0.23 , p < 0.001 ) . PNIF increased progressively during Opt-FP treatment ( p < 0.05 ) . Combined symptom score , nasal blockage , discomfort , rhinitis symptoms and sense of smell were all significantly improved . Rescue medication use was lower ( 3.1 % vs 22.4 % , p < 0.001 ) . Opt-FP was well tolerated . CONCLUSIONS Fluticasone propionate ( 400 microg b 
    Output:
    
Conclusion INCS is effective for CRS .
Prior sinus surgery and direct sinus delivery enhance the effectiveness of INCS in CRS