Nasal polyps are inflammatory growths in the nose and sinuses that can obstruct the nose and sinuses, leading to nasal blockage, recurrent infections, loss of sense of smell and taste, and other sinus symptoms including headaches, snoring, nasal congestion, and sinus drainage. Generally, They’re usually not cancerous but they may be related to asthma, recurrent infections, allergies, drug sensitivity, or an underlying immune disorder. Nasal polyps are most commonly found in adults. They may be treated successfully with medications, but if not, then surgical removal may be required. Polyps frequently recur even after successful treatment. For this and other reasons, nose and sinus symptoms must be evaluated by a specialist. Physicians at the Nose and Sinus Center can perform a complete fiberoptic evaluation of your nose to determine if there are any polyps visible. If there are polyps present, they will discuss a wide range of treatment options with you. Often, simple medications can result in significant improvement and symptom resolution. Recent technology has made these treatments generally more effective, safer, and more comfortable than ever before. For more information on surgery for nasal polyps, see Dr. Becker’s published paper, The Surgical Management of Nasal Polyps.
When to see a doctor
If you’re experiencing nasal polyps, you should definitely see a doctor, especially if your symptoms last more than 10 days. Nasal polyps are often associated with allergies, sinus infections, asthma, chronic obstructive pulmonary disease (COPD), and other respiratory conditions.
Nasal Polyps Causes
Polyps develop when the mucous membranes that line the nose or sinuses swell up and get inflamed. This swelling may last for a long time or it may get worse over and over again.
Researchers believe that allergies can trigger an inflammatory response that leads to nasal polyps. Based on tissue samples removed from nasal polyp patients. Those samples contained extra leukocytes, and white blood cells associated with infection and allergy. The proof suggests that allergies causes swelling within the tissues, resulting in polyp formation. Polyp formation leads to the development of nasal polyposis.
Nasal Polyps Symptoms
Symptoms of polyps include:
- Runny nose
- postnasal drip
- sore throat
- ear pain
- sinus pressure
- loss of appetite
- body aches.
If you’re experiencing any of these symptoms, visit your doctor right away. The sooner you seek treatment, the better off you’ll be.
Nasal Polyps Diagnosis and Tests
Nasal polyps usually appear during diagnostic rhinoscopy exams. They’re often associated with trouble breathing through the patient’s nostrils and may cause them to lose their sense of taste and/or smell.
Your doctor at Becker ENT and Allergy may evaluate these and other signs and perform an exam of your nose. If necessary, he or she may use a special lighted nasal device to examine your nose for polyps.
You may be advised by your physician to undergo additional tests, which include a nasal endoscopy to examine your nose and mouth, a CT scan to measure its size, shape, and position, or allergy tests to identify the cause of your chronic sinusitis symptoms.
Nasal Polyps Treatment
There are no known cures for nasal polyps. However, some treatments are used to relieve symptoms. These include medications, surgery, and endoscopic procedures. Medications can help reduce swelling and inflammation. Surgery is often recommended for severe cases. Endoscopy involves inserting a thin tube through the nostril and removing tissue samples. This procedure is commonly performed in conjunction with surgery.
Nasal Polyps FAQs
Most polyps in the nose and sinuses are the byproduct of an inflammatory process. It is unclear what drives this inflammatory process — viruses, allergies, bacteria, environmental irritants have all been proposed. For some reason, however, it appears that an inflammatory cascade is triggered that leads to swelling of the nasal and sinus lining and, ultimately, to the development of polyps.
Polyps can form in the nose, or in the sinuses themselves. When they are present in the nose, they may lead to nasal obstruction alone. If they become large enough, polyps can block the drainage pathways of the sinuses. When the sinus drainage pathways are obstructed, the normal sinus function will be affected and patients may develop the signs and symptoms of chronic sinusitis.
In most cases, polyps are benign growths. On occasion, however, the presence of polyps may be a manifestation of a tumor or a cancer. Any patient with sinus or nasal polyps should be seen by a trained otolaryngologist who can perform a nasal endoscopy in the clinic. This procedure is very well tolerated, and takes only a few minutes. This will allow your doctor to examine the polyps closely. If the polyps are concerning for a tumor, your doctor may decide to obtain imaging (CT scan, MRI) to help define the extent of the polyp. Your physician may also decide to perform a biopsy for a definitive diagnosis. A biopsy may be performed in the clinic or in the operating room depending on the case. If a biopsy is recommended, your physician will discuss these options with you.
Again, in most cases, polyps are benign growths. However, a trained otolaryngologist should examine patients with polyps to make sure that the polyp does not represent another type of mass. Encephalocoeles (herniated brain tissue) can present as a nasal or sinus polyp. Inverted papilloma is a benign tumor with a small incidence of malignant degeneration that also may present as a simple polyp. Some other lesions that may present with polyps include juvenile nasopharyngeal angiofibroma, pleomorphic adenoma, sarcoidosis, Wegeners disease, adenocarcinoma, and squamous cell carcinoma.
Some studies have found polyps to be present in as many as 1-4 percent of people in the general population.
There is increased prevalence of polyps in some patient groups. Patients with asthma and aspirin intolerance are more likely to have polyps than those without these conditions. Patients with cystic fibrosis, and other conditions (Churg-Strauss syndrome, ciliary dysfunction syndrome) also have an increased prevalence of sinonasal polyps.
Many patients do not know that they have sinus polyps. Other patients who have complete nasal obstruction from massive polyposis that blocks all nasal airflow and impedes sinus function are well aware of their condition. Common symptoms include nasal obstruction, diminished sense of smell (hyposmia), and sinusitis. Any patient with a concern for the presence of polyps should be evaluated by an otolaryngologist who can look into the nasal cavity with a small endoscope and evaluate for the presence of polyps.
An antrochoanal polyp is a benign polyp that typically has its stalk in the maxillary sinus (The “cheek” sinus located below the eye). The polyp enlarges until it passes out of the sinus and into the nasal cavity. These masses can grow to be quite large and may distort the surrounding anatomy. Once they grow into the choana (the pathway through which air passes from the nose into the throat), patients symptoms may worsen as nasal breathing becomes increasingly difficult. Sometimes the polyp may actually extend all the way to the opposite choana and block nasal breathing from both sides.
Medicines for the treatment of nose and sinus polyps mostly rely on an anti-inflammatory effect. Oral steroids (i.e., prednisone) are often quite effective in shrinking polyps, however, the risks of long-term treatment with oral steroids is often felt to outweigh the benefits of treatment. Most physicians, therefore, use oral steroids in bursts to help patients with polyps who are having a bad episode of swelling. Topical steroids (nasal steroid sprays) can be used on a more long-term basis to help patients decrease the inflammation associated with nasal and sinus polyps. Other novel preparations are available, but the relative risks and benefits should be discussed with your physician.
In some patients with a significant bulk of polyps it may be necessary to surgically remove the polyps so that topical medications can be effective. In many patients with polyps, the sinuses have also developed a chronic inflammatory state, and may need to be opened as well, so that they may return to normal function.
In many patients with hyposmia (decreased sense of smell), decreasing the polyp burden (either with medicines and/or nasal surgery Princeton) may lead to improvement in the sense of smell. Patients should be aware, however, that not all patients will have their sense of smell return or improve, and it can be difficult to predict which patients will benefit from treatment.
Most patients who have their polyps treated effectively with medicines and/or nasal surgery Princeton will have improvement in their nasal airflow and function.
Polyps are the byproduct of a chronic inflammatory process. The key word here is chronic. No medicine or nasal surgery can cure you of your polyps (much like no medicine or nasal surgery can cure you of high cholesterol or hypertension) but they can be managed and brought under control so that you may have a significant improvement in your quality of life. Once removed, polyps will have a tendency to regrow. Fortunately, with a combination of topical sprays and drops, and occasional oral medications, most patients can keep their polyps under control.