What Are Nasal Polyps?
These are non-cancerous growths. They may be brown or pink. They may grow alone or in bunches, taking on the form of grapes. They can occur on one side of your nose, but more often they are present on both sides. Nasal polyps are not associated with polyps in other parts of the body (such as the colon).
Symptoms of Nasal Popyps
Usually, small nasal polyps don’t cause symptoms; however, larger growths can block your nasal passages and sinuses leading to breathing problems, a lost sense of smell, and frequent infections.
For patients who already have chronic sinusitis, the addition of nasal polyps may cause sinusitis symptoms, such as these, to worsen:
- A runny nose
- Persistent stuffiness
- Postnasal drip
- Decreased or absent sense of smell
- Loss of sense of taste
- Facial pain or a headache
- Pain in your upper teeth
- A sense of pressure over your forehead and face
Causes Of Nasal Polyps
If your parents or siblings have/had polyps, there is a good chance you will have them as well. Genetics and age are strong factors in risk for polyps.
Polyps are not a disease. They are a swelling of tissue. People with allergies, asthma and cystic fibrosis all are at higher risk of getting polyps. Tissue swells, becomes filled with fluid, and then eventually forms the polyps.
Complications of Nasal Polyps
Nasal polyps can cause complications, because they block normal airflow and fluid drainage, and because your system is in a chronic state of inflammation. Some potential complications that could occur include obstructive sleep apnea, asthma flare-ups (chronic rhinosinusitis can aggravate asthma), and sinus infections (nasal polyps make you more susceptible to sinus infections).
How ENTs Diagnose Polyps
After reviewing your medical history, your otolaryngologist (ENT) will perform an examination. Sometimes the polyps are visible with only the aid of a lighted instrument. In addition to a simple exam, the several procedures may be performed.
Computerized tomography is a digital process where many x-ray images are taken of your sinuses to create a three dimensional image. Your ENT can use a CT scan to see polyps or any other issues in the nasal and sinus area.
A nasal endoscope is a small, thin-lighted instrument with a camera that the ENT can be inserted in your nose to see the entire nasal passage. Your ENT is skilled with the use of an endoscope, as this is the same instrument used to perform certain nasal procedures.
ENT Treatment Of Nasal Polyps
There are two approaches to treating polyps: surgical and non-surgical. Both play an important role in the treatment and management.
Non-surgical treatment is focused on reducing the size of the polyps and treating any underlying infection.
Nasal Corticosteroid rinses are often prescribed to reduce inflammation. Treatment may help shrink the polyps or eliminate them completely.
Oral steroids may also be prescribed intermittently to reduce their size. These are not the same steroids that are abused by athletes and bodybuilders. As a precaution, they are only prescribed for a short time period due to side effects.
Antibiotics: These may be prescribed to treat chronic or recurrent infections.
Antihistamines: These are prescribed to treat allergies that contribute to chronic inflammation in your sinuses or nasal passages. This may be a spray, pill or combination of both.
In addition, your ENT will likely recommend allergy testing to see if you have allergies. If allergies are causing the polyps, these will be addressed with medications, allergy shots or allergy drops. If you have an infection, antibiotics may be prescribed.
There are several options for new and state of the art treatments including monoclonal antibodies.
These are safe and effective ways to help control your nasal polyp symptoms and can also improve symptoms of asthma, chronic hives, and atopic dermatitis. This is a safe treatment that helps avoid prolonged and repeat courses of oral steroid therapy.
If you don’t respond to the non-surgical methods of treatment or if your nasal polyps are very large, surgery will be the recommended approach. Types of surgical treatments include:
If the polyps are in the nasal passages, your ENT will perform a Polypectomy. This is done under local or general anesthetic. The polyps are removed from the nasal passages and a saline spray may be recommended during the brief recovery process. Often times we will place a dissolvable stent in your sinuses called Propel to decrease the risk of polyps re-growing.
If the polyps can’t be reached with a simple polypectomy, your ENT will use his nasal endoscope to get through the nasal passages and into the sinus area to remove polyps.
If you have had previous sinus surgery and continue to have issues with polyps, you likely qualify for minimally invasive procedure. A simple approach to place a drug eluting stent placed in your nasal cavity called Sinuva.
Nasal Polyps Can Return
It should be noted that no matter the treatment, nasal polyps can return. That is why it is important to determine the cause of your chronic inflammation so that we can help prevent nasal polyps from returning.