Nasal Polyps

Nasal Polyps…

are benign (non-cancerous), painless thin soft tissue growths that can block the nasal passages and sinuses when irritated.

WHAT are Nasal Polyps?

Nasal passages are soft, painless tissue growths that are non-cancerous and are often shaped like teardrops that hang down from the lining of your nose or sinuses. They tend to form in groups in the nasal and sinus passages. Small nasal polyps may not cause any symptoms; however the larger growths or groups of nasal polyps can block your nasal passages, leading to breathing problems, a loss of smell and frequent infections.

Nasal polyps can form anywhere in the nasal passages and sinuses, but they more often develop in the sinus area near the eyes, nose and cheekbones.

Nasal polyps can form at any age but they most commonly develop in young and middle-aged adults.

TYPES OF Nasal Polyps:

There are two types of nasal polyps.

ETHEMOIDAL POLYPS: these are the most common type of polyp. They develop from the ethmoidal sinuses, which are located between the nose and the eyes.

ANTROCHOANAL POLYPS: these are less common, and they develop in the maxillary sinuses that are located above the teeth and below the cheeks and nose.

WHAT CAN CAUSE nasal Polyps?

When the lining in the nasal passages and sinuses have been irritated and swollen for longer than eight weeks (chronic sinusitis) to twelve weeks (chronic rhinositis), nasal polyps can often develop. Due to the complexity of the condition, scientists do not fully understand why this type of irritation and swelling can trigger nasal polyps to form in some people. It is thought that perhaps the development of polyps has to do with the person’s individual immune system responses as well as different chemical markers present in their mucous membranes that are not present in those that do not develop polyps.

Certain conditions can trigger longer term irritation and swelling in the nasal passages or sinuses, and may increase the risk of developing nasal polyps. These conditions can include:

• Asthma
• Aspirin sensitivity
• Allergic fungal sinusitis (an allergy to airborne fungi)
• Cystic fibrosis (a genetic disorder that results in abnormally thick, sticky fluids in the body, including thick mucus from nasal and sinus linings
• Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis - a rare disease that causes inflammation of the blood vessels
• Vitamin D deficiency

Diagnosis and Treatment of Nasal Polyps

Nasal Polyps SYMPTOMS

Symptoms of nasal polyps are similar to several other conditions including an ordinary cold. If these symptoms last more than 10 days, it’s likely time to see the doctor. Common symptoms that are associated with having or developing nasal polyps are similar to those caused by chronic sinusitis and can include the following:

• Runny nose
• Persistent stuffiness
• Postnasal drip
• Difficulty breathing through the nose
• Decreased or absence of sense of smell (anosmia)
• Loss of sense of taste
• Facial pain or headache
• Pain in upper teeth
• Pressure over forehead, face or sinuses
• Itching around the eyes
• Snoring
• Frequent nosebleeds

You should seek immediate attention or call 911 if you should experience:

• Serious trouble breathing
• Sudden worsening of your symptoms
• Double vision, reduced vision or limited ability to move your eyes
• Severe swelling around your eyes
• Increasingly severe headache accompanied by a high fever or the inability to tip head forward.

How Are Nasal Polyps diagnosed?

Your rhinologist will make a diagnosis based on your answers to questions about your symptoms, do a general examination and an examination of your nose, usually with a special lighted instrument called a nasoscope. The rhinologist may also choose to perform certain additional tests like a nasal endoscopy to better determine where the polyps are located. When an endoscopy is required, the rhinologist will use a nasal endoscope which is a small thin telescope with a camera on the end to look inside your nose. In some cases, the doctor may take a small sample (biopsy) of the polyp or growth. Sometimes the doctor may want to have further imaging studies performed such as a computerized tomography (CT) or magnetic resonance imaging (MRI) to confirm the presence of nasal polyps. Such imaging can also further pinpoint the size and location of any polyps in the deeper areas of the sinuses.

Other tests may be suggested including a blood test, allergy tests, and possibly a test for cystic fibrosis.

How are nasal polyps treated?

Reducing or eliminating the nasal polyps is the ultimate goal. The first approach is generally to use medications like a nasal corticosteroid spray or oral corticosteroids to reduce the inflammation. These medications can sometimes shrink or even get rid of the polyps completely. If the medications cannot successfully treat the nasal polyps, endoscopic surgery may be necessary to remove the nasal polyps. In an outpatient procedure, the surgeon will remove the polyp(s) that is preventing the flow of sinus and nasal fluids from properly draining and ventilating your sinus and nasal passages.

Should a surgery be necessary, it it important that proper care be taken of the nasal area to ensure the nasal polyps do not return. Treatment strategies usually include the continued use of a either a corticosteroid spray or an oral or injectable form of steroid. The use of a humidifier can also help to moisten the air in the environment, which will in turn help to keep your nasal passages more moist. Keeping the nasal passages more moist will help improve the flow of mucus in your sinuses, and help prevent blockage and inflammation that might lead to the return of nasal polyps. Nasal sprays or rinses can also help to moisten the nasal passages and help prevent inflammation. Washing the sinus and nasal cavities with a sterile saline solution is also important to help with proper healing.

If you have allergies or asthma, it is recommended that you avoid any nasal irritants like dust, smoking, and common allergens that can cause inflammation as best you can. It is important to follow your doctor’s individualized treatment plan for managing both or either of these conditions.