Nasal Polyp (Nose Polyps)

Nasal polyposis (Nose polyps) occurs when tissue within the nose swells and grows outward, creating soft and painless sacs of tissue. No conclusive cause for nasal polyposis has been established, but they are thought to be caused by chronic inflammation due to allergies or chronic sinus infections, and can be associated with asthma in adults and cystic fibrosis in children. More recently, an allergy to fungal spores in the air has been identified as a major risk factor for nasal polyps.

Lateral View of Nasal Polyps

What are the symptoms of nasal polyps?

-Nose is always blocked (nasal congestion)
-Constant runny nose or postnasal drip
-Decreased or loss of sense of smell (anosmia) or taste
-Headache or forehead and cheek pain
-A bad head cold that does not go away

How are nasal polyps diagnosed?

A doctor can often detect polyps simply by looking in the front of the nose with a headlight. For a more complete examination, the doctor can use a narrow lighted tube with a magnifying lens (nasal endoscope) to look deeper inside the nasal cavity. A CAT scan of the sinuses will show areas that cannot be seen by looking into the nose and can show the extent to which the polyps are filling the sinuses.

CT Scan of Frontal Sinus Polyps

The doctor can use skin or blood allergy testing to determine if allergies might be causing some of the inflammation.

What are the potential complications of nasal polyposis?

Patients may have recurrent sinus infections from obstructive nasal polyps. If the infections do not resolve after 3 months then the infection becomes a chronic sinus infection. Large polyps may eventually compress the eyes or push on the brain. Nasal obstruction can cause snoring or even sleep apnea, a condition that stops your breathing during sleep and can cause serious heart and lung damage.

What medical treatments are available?

Avoidance of known causative factors for nasal polyps is important. A saline rinse or net pot may be useful. Nasal or oral steroids can reduce inflammation and may shrink nasal polyps. Oral or nasal antihistamines can decrease symptoms of allergies. Bacterial sinus infections that do not resolve after 7 to 10 days should be treated with antibiotics. For fungal sinusitis, an antifungal medication, steroids, immunotherapy, and avoidance of the exposure to the fungus may be effective.

If your nasal polyps prove resistant to conservative treatment and medications, then they can be removed in an ambulatory sinus surgery procedure (polypectomy). If you are experiencing sinus inflammation, endoscopic sinus surgery can ventilate and provide drainage to the sinuses. You will generally go home about an hour after surgery. You may feel congested following surgery, but your breathing may also be better immediately.

Photograph of a Nasal Polyp

Can I prevent nasal polyps from coming back?

The patient and doctor must maintain constant vigilance after nasal polyp removal. Unfortunately, nasal polyps will return in approximately 2 out of every 3 people who experience them. With a thorough surgery by an experienced sinus surgeon, steroid rinses and oral steroids will decrease the chance of polyp return. Saline rinses may decrease irritation in some patients. Air purification is always a good idea, as the air inside the home can have 5 to 10 times as many impurities as outside air. Avoiding dust, pollution, and irritating chemicals can decrease nasal swelling. Humidifiers can keep the inside lining of the nose moist in the winter or in dry environments but too much humidification will promote the growth of dust mites. Medical treatment of allergies and asthma will also decrease inflammation inside the nose. Hand washing and covering your nose when you sneeze are some of the best ways to prevent the spread of viral and bacterial infections that may aggravate the polyposis.

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