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Nasal Polyps Treatment in Philadelphia and New Jersey
Home / ENT / Nasal Polyps

Nasal Polyps Treatment

Nasal polyps are inflammatory growths in the nose and sinuses that can obstruct the nose and sinuses, leading to nasal blockage, recurrent infections, and loss of sense of smell and taste. Nasal polyps can also cause other sinus symptoms including headaches, snoring, nasal congestion, and sinus drainage. They’re may be related to asthma, recurrent infections, allergies, drug sensitivity, or underlying immune disorders. 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, a specialist must evaluate nose and sinus symptoms.

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The information provided below and throughout this website is presented for general educational purposes only and does NOT constitute professional medical advice. This information is NOT a substitute for professional medical advice and NO material on this site is intended to be a substitute for professional medical advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding a health or a medical condition. Never disregard the advice of a medical professional or delay in seeking it because of something you have read on this website.

Physicians at the Penn Medicine Becker ENT & Allergy Center can perform a complete fiberoptic evaluation of your nose to determine if any polyps are visible. If polyps are present, the physicians will discuss a wide range of treatment options with you. Often, taking 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.

Table Of Contents
  1. When to See a Doctor
  2. Understanding the Underlying Causes of Nasal Polyps
  3. Recognizing Nasal Polyps: Symptoms Indicating Advanced Treatment Needs
  4. Nasal Polyps Diagnosis and Tests
  5. Advanced Treatment Options for Nasal Polyps
  6. Nasal Polyps FAQs

When to See a Doctor

If you’re experiencing this condition, you should definitely see a doctor, especially if your nasal polyps symptoms last more than 10 days. Nasal polyps can be associated with other conditions such as allergies, sinus infections, asthma, to name a few.

Understanding the Underlying Causes of Nasal Polyps

Genetic Predisposition and Environmental Interactions

Emerging research suggests a significant genetic component to nasal polyps, with certain genes making individuals more susceptible to chronic sinusitis and polyp formation. A study published in the “Journal of Allergy and Clinical Immunology” identified specific genetic markers associated with an increased risk of developing chronic rhinosinusitis with nasal polyps. This research opens the door to personalized medicine approaches, where treatments can be tailored based on an individual’s genetic makeup.

Environmental factors may play a crucial role in the development of nasal polyps as well. Exposure to pollutants, cigarette smoke, and occupational hazards can exacerbate inflammation in the nasal passages and sinuses, and may contribute to polyp growth. A comprehensive review in “Environmental Health Perspectives” highlights the interaction between genetic predisposition and environmental triggers, suggesting that reducing exposure to harmful substances could mitigate the risk of polyps in genetically susceptible individuals.

The Role of the Microbiome in Nasal Health

The nasal microbiome, the community of microorganisms residing in the nasal cavity, has recently come under scrutiny for its potential role in nasal polyp formation. An imbalance in these microbial communities can lead to increased inflammation and polyp development. Research in “The Lancet Microbe” has demonstrated that individuals with nasal polyps often have a significantly altered nasal microbiome compared to those without polyps. These findings suggest that restoring a healthy microbial balance could be a novel approach to preventing or treating nasal polyps.

Immunological Insights: Beyond Allergies

While allergies may contribute to nasal polyp development, recent studies have broadened our understanding of the immunological aspects of polyps. Chronic inflammation, driven by a complex interplay of immune cells and signaling molecules, is at the heart of polyp formation. Innovative research published in “Nature Immunology” has identified specific immune pathways that are overactive in patients with nasal polyps. Targeting these pathways with new therapeutic agents could offer more effective treatments for patients who do not respond to traditional therapies.

Recognizing Nasal Polyps: Symptoms Indicating Advanced Treatment Needs

Some common symptoms of polyps include:

  • Decrease in smell and/or taste
  • Nasal blockage and congestion
  • Runny nose
  • Sneezing
  • Postnasal drip
  • Sinus pressure
  • Fatigue

If you notice any of these symptoms, it is advisable to seek medical attention from your healthcare provider. The sooner you seek treatment, the sooner a diagnosis may be made and treatment can begin.

Navigating Nasal Polyps: Recognizing the Red Flags
Breathing Troubles: Unveiling Nasal Polyps Symptoms

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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 patients to lose or have a diminished 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 (endoscope) 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 help  identify other contributing factors to your symptoms.

Advanced Treatment Options for Nasal Polyps

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 may be recommended for some cases but is intended as a means to open up the nasal and sinus cavities to allow topical medications to work effectively. Surgery is not a cure for nasal polyps.

Propel

Millions of people suffer from nasal polyps or chronic sinusitis. There are many different treatment options available, but not everyone responds well to them. A newer option for addressing these two conditions is the PROPEL sinus implant after a sinus procedure or SINUVA sinus implants.
There are many different treatment options available for nasal polyps

Millions of people suffer from nasal polyps or chronic sinusitis. There are many different treatment options available, but not everyone responds well to them. One option for addressing these two conditions is the Propel sinus implant after a sinus procedure or SINUVA sinus implants.

The Propel stent is commonly placed during FESS, or functional endoscopic sinus surgery, to decrease the swelling and assist in the healing of the sinus passages. When you have chronic sinusitis, normal drainage is often prevented due to sinus passage inflammation. During surgery, these passages are enlarged. However, in some cases, post-surgical scarring can occur, and polyps may regrow, leading to a return of sinus inflammation, swelling, and, in some cases, infections.

This is where a Propel implant can make a difference. After completing the surgery, the Propel sinus implant is inserted. It is a spring-like device that helps to keep your sinuses open. The implant also contains mometasone furoate, a type of medication, which releases slowly to limit polyp regrowth and scarring to promote healing. Over the course of about one month, the implant will dissolve.

This is where a Propel implant can make a difference. After completing the surgery, the Propel sinus implant is inserted. It is a spring-like device that helps to keep your sinuses open. The implant also contains mometasone furoate, a type of medication, which releases slowly to limit polyp regrowth and scarring to promote healing. Over the course of about one month, the implant will dissolve.

During FESS surgery, you are typically given general anesthesia so that you are asleep and can feel no discomfort. Once you are anesthetized, an endoscope is inserted into your nostrils to allow the surgical team to visualize the area. Precision surgical instruments are then used to reposition or remove any necessary tissue. Once the procedure is completed, the implant is placed to keep the sinuses open.

In most cases, FESS is performed as an outpatient procedure, so you can go home the same day. For about a week, you may experience minor pain, swelling, and stuffiness. Your surgeon will provide detailed recovery instructions and any necessary medications to promote healing and recovery.

Sinuva

SINUVA is an implant that is designed for patients who are over the age of 18, have nasal polyps, and who have a history of ethmoid sinus surgery. This technology may be an option if you do not want to repeat sinus surgery.
Nasal Polyps diagram

Sinuva is an implant designed for patients who are over the age of 18, have nasal polyps, and have a history of ethmoid sinus surgery. This technology may be an option if you do not want to repeat sinus surgery.

Once the implant is in place, it begins to release mometasone furoate, a medicine that works to alleviate inflammation and nasal polyps. Once the doctor places the implant, the device uses a two-in-one approach to reduce the symptoms of congestion, nasal obstruction, and polyps. It does this by keeping the sinus cavity open while releasing the medication directly into sinus tissue.

The procedure to put this implant into place is simple. It can be performed in the office, and you can go home shortly after it is completed.

Your doctor will first numb your nose to help you stay comfortable. Through the nasal opening, the doctor will insert the implant into your ethmoid sinus. Once it is in place, you usually cannot feel it, so patients do not typically complain about long-term discomfort due to the implant.

The implant can remain in place for up to 90 days to keep your sinus open and to reduce symptoms of nasal congestion and obstruction. However, you can have it removed sooner at your doctor’s discretion.

Dupixent

Dupixent may be an option for patients with chronic rhinosinusitis with polyps that is poorly controlled with medications. Dupixent is a medicine that is injected just below the skin. It is typically given in the abdomen or thigh, but the back of the upper arm is also an acceptable injection site.

This medicine is classified as a biologic. It works to suppress and target the specific elements that trigger immune system inflammation. Injections are given every two weeks.

If intranasal steroids and other medications are not adequately controlling your nasal polyps and related symptoms, then Dupixent could be a viable alternative. It may also reduce the need for surgery to remove nasal polyps.

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Nasal Polyps FAQs

What are sinus polyps?

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, and 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.

How do polyps affect the sinuses?

Polyps can form in the nose, or in the sinuses themselves. When they are present in the nose, they may alone lead to nasal obstruction. 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.

Are sinus polyps cancerous?

In most cases, nasal and sinus 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 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.

What else could a nose or sinus polyp be?

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. An 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, Wegener’s disease, adenocarcinoma, and squamous cell carcinoma.

How common are polyps?

Some studies have found polyps to be present in as many as 1-4 percent of people in the general population.

Are some patients more likely to have polyps than others?

There is an 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.

How do I know if I have sinus polyps? What symptoms will I have if I have 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.

What is an antrochoanal polyp?

An antrochoanal polyp is a benign polyp that most commonly has its stalk in the maxillary sinus area (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.

What medicines can be used to treat nose and sinus polyps?

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 thought 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.

Is there a role for nasal surgery for the treatment of polyps?

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.

If my polyps are treated, can I get my sense of smell and taste back?

In many patients with hyposmia (decreased sense of smell), decreasing the polyp burden (either with medicines and/or nasal/sinus surgery) 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.

If my polyps are treated, will my nasal breathing and congestion be improved?

Most patients who have their polyps treated effectively with medicines and/or nasal surgery will improve their nasal airflow and function.

If polyps are removed, will they grow back?

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 can significantly improve 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.

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