Nasal Polyps

Nasal Polyps - About

Nasal polyps are soft, noncancerous overgrowths of the mucous membranes lining your nasal passages or sinuses. The growths are soft, sac-like and usually painless but face pain may occasionally occur. When polyps are present they typically occur in both nostrils. Small nasal polyps may not cause symptoms. Larger growths or groups of nasal polyps can block your nasal passages or lead to breathing problems, a lost sense of smell, and frequent infections. Complications may include sinusitis. It is not clear why some people get nasal polyps. They can result from chronic inflammation due to environmental irritants, recurring infection, allergies, drug sensitivity or certain immune disorders. Nasal polyps are often associated with asthma.

Nasal polyps are more common in adults. Medications can often shrink or eliminate nasal polyps, but surgery is sometimes needed to remove them. Even after successful treatment, nasal polyps often return.

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Nasal Polyps - Diagnosis

Nasal polyps are often visible if your doctor looks up into your nasal passages with a lighted instrument called an otoscope or nasoscope. If the polyp is deeper in your sinuses, your doctor may need to perform a nasal endoscopy. This procedure involves your doctor guiding a thin tube with a light and camera at the end into your nasal passages.

Images from a computerized tomography (CT) scan or from magnetic resonance imaging (MRI) can help your doctor pinpoint the size and location of polyps in deeper areas of your sinuses and evaluate the extent of inflammation. These studies may also help your doctor rule out the presence of other possible obstructions in your nasal cavity, such as structural abnormalities or another type of cancerous or noncancerous growth.

Allergies can contribute to chronic inflammation and your doctor may suggest tests for allergies. With a skin prick test, tiny drops of allergy-causing agents (allergens) are pricked into the skin of your forearm or upper back. Your doctor or nurse then observes your skin for signs of allergic reactions. If a skin test can't be performed, your doctor may order a blood test that screens for specific antibodies to various allergens.

Nasal polyps in very young children are uncommon and may be a sign of something more serious. Your doctor may recommend tests for genetic diseases, such as cystic fibrosis.

Nasal Polyps - Treatment

Chronic sinusitis, with or without polyps, is a challenging condition to clear up completely. You'll work with your health care team to develop the best long-term treatment plan to manage your symptoms and to treat factors, such as allergies, that may contribute to chronic inflammation.

The treatment goal for nasal polyps is to reduce their size or eliminate them. Medications are usually the first approach. Surgery may sometimes be needed but may not be a permanent solution because polyps tend to recur.

Medications

Nasal polyp treatment usually starts with medications. Medications can be highly effective to help relieve symptoms, but rarely get rid of nasal polyps.

Nasal steroid sprays shrink polyps. They reduce inflammation and help clear blocked nasal passages and runny nose. Symptoms return if treatment is stopped.
Corticosteroid pills or liquid may also shrink polyps, and can reduce swelling and nasal congestion. Injectable corticosteroids may be recommended if nasal polyps are severe. In most cases the effect lasts a few months.
Allergy medicines can help prevent polyps from growing back.

Surgery

If drug treatment doesn't shrink or eliminate nasal polyps, you may need endoscopic surgery to remove polyps. Surgery can also often correct any problems with your sinuses that make them prone to inflammation and polyp development. Sometimes, polyps come back, even after surgery.

Endoscopic surgery involves inserting a small tube with a magnifying lens or tiny camera (endoscope) into your nostrils and guiding it into your sinus cavities. The physician uses tiny instruments to remove polyps and other obstructions that block the flow of fluids from your sinuses.

Your physician may also enlarge the openings leading from your sinuses to your nasal passages. Endoscopic surgery is usually performed as an outpatient procedure.

After surgery, you'll likely use a corticosteroid nasal spray to help prevent the recurrence of nasal polyps. Your physician may also recommend the use of a saltwater (saline) rinse to promote healing after surgery.