Estadiamento endoscópico tridimensional da polipose nasal antes e após corticoterapia oral

Abstract

Nasal Polyposis (NP) is a chronic inflammatory process of the nasalmucosa, characterized by multiple and bilateral nasal polyps. It represents the manifestation of different diseases that affect the nasal cavities. Its pathophysiology is controversial, as is its treatment. However, there is a consensus that steroids are always necessary for its control. In order to study the results of different treatment modalities it is necessary to have some kind of staging. In the present paper, we present a new endoscopic staging method, based on nasal endoscopy and on the tridimentional polyps assessment; and we compare its reproducibility with that from two other systems already established in the literature. Three experts assessed the exams of 20 patients at different times,before, at 15 and at 30 days after the onset of oral steroids treatment. Weassessed the agreement rate among the experts and also compared treatment results through staging. The results showed a significant agreement among the three experts for the three classifications in most of the assessements. After treatment we did not notice any significant difference in nasal involvement scores considering the three stages analyzed, except for one assessment of the threedimensional method. We then conclude that the staging system proposed presents acceptable reproducibility, the other two methods were also reproducible and were more concordant than the tridimentional method, and the seven daytreatment with oral steroids only showed significant alteration in polyp scores for one of the assessments of the three-dimensional method.