What Are Nasal Polyps?
Have you ever felt like you have a cold that doesn’t go away?
Nasal congestion that doesn’t seem to stop, even with over-the-counter cold or
allergy medication, may be due to nasal polyps.
Nasal polyps are benign (noncancerous) growths of the lining
tissues, or mucosa, of your nose.
What Are the Causes of Nasal Polyps?
Nasal polyps grow in inflamed tissue of the nasal mucosa.
The mucosa is a very wet layer that helps protect the inside of your nose and
sinuses and humidifies the air you breathe. During an infection or allergy-induced
irritation, the nasal mucosa becomes swollen and red, and it may produce fluid
that drips out. With prolonged irritation, the mucosa may form a polyp. A polyp
is a round growth (like a small cyst) that can block nasal passages.
Although some people can develop polyps with no previous
nasal problems, there’s often a trigger for developing polyps. These triggers
- chronic or recurring sinus infections
- allergic rhinitis, or hay fever
- cystic fibrosis
- Churg-Strauss syndrome
- sensitivity to non-steroidal anti-inflammatory
drugs (NSAIDs), which is an allergy-like response to anti-inflammatories such
as ibuprofen or aspirin
There may be a hereditary tendency for some people to
develop polyps. This may be due to the way their genes cause their mucosa to
react to inflammation.
Are the Symptoms of Nasal Polyps?
Nasal polyps are soft, painless growths inside the nasal
passages. They often occur in the area where the upper sinuses drain into your
nose (where your eyes, nose, and cheekbones meet). You may not even know that
you have polyps because they lack nerve sensation.
Polyps can grow large enough to block your nasal passages,
resulting in chronic congestion. Symptoms can include:
- a sensation that your nose is blocked
- runny nose
- postnasal drip, which is when excess mucus runs
down the back of your throat
- nasal stuffiness
- nasal congestion
- reduced sense of smell
- breathing through your mouth
- a feeling of pressure in your forehead or face
- sleep apnea
Pain or headaches may also occur if there’s a sinus
infection in addition to the polyp.
Are Nasal Polyps Diagnosed?
A nasal polyp will likely be visible if your doctor looks up
into your nasal passages with a lighted instrument called an otoscope or
nasoscope. If the polyp is deeper in your sinuses, your doctor may need to
perform a nasal endoscopy. This procedure involves your doctor guiding a thin,
flexible tube with a light and camera at the end into your nasal passages.
A CT or MRI scan may be necessary to determine the exact size
and location of the polyp. Polyps show up as opaque spots on these scans. Scans
can also reveal whether the polyp deformed the bone in the area. This can also
rule out other kinds of growths that may be more medically serious, such as
structural deformities or cancerous growths.
Allergy tests can help doctors determine the source of
persistent nasal inflammation. These tests involve making tiny skin pricks in
your skin and depositing the liquid form of a variety of allergens. Your doctor
will then see if your immune system reacts to any of the allergens.
If a very young child has nasal polyps, tests for genetic
diseases, such as cystic fibrosis, may be necessary.
Treatments Are Available for Nasal Polyps?
Medications that reduce inflammation may help reduce the
size of the polyp and relieve symptoms of congestion.
Spraying nasal steroids into the nose can reduce your runny
nose and the sensation of blockage by shrinking the polyp. However, if you stop
taking them, symptoms may quickly return. Examples of nasal steroids include
fluticasone (Flonase, Veramyst), budesonide (Rhinocort), and mometasone
An oral or injectable steroid, such as prednisone, may be an
option if nasal sprays don’t work. These aren’t a long-term solution due to
their serious side effects, including fluid retention, increased blood
pressure, and elevated pressure in the eyes.
Antihistamines or antibiotics may also treat allergies or
sinus infections caused by inflammation in the nose.
If your symptoms still aren’t improving, surgery can remove
the polyps completely. The type of surgery depends on the size of the polyp. A
polypectomy is an outpatient surgery done with a small suction device or a
microdebrider that cuts and removes soft tissue, including the mucosa.
For larger polyps, your doctor can perform an endoscopic
sinus surgery using a thin, flexible endoscope with a tiny camera and small
tools on the end. Your doctor will guide the endoscope into your nostrils, find
the polyps or other obstructions, and remove them. Your doctor may also enlarge
the openings to your sinus cavities. This type of surgery is an outpatient
procedure most of the time.
After surgery, nasal sprays and saline washes can prevent
polyps from returning. In general, reducing the inflammation of the nasal
passages with nasal sprays, anti-allergy medications, and saline washes can
help prevent nasal polyps from developing.
Are the Potential Complications of Nasal Polyps?
Treating nasal polyps, especially with surgery, may result
in nosebleeds. Surgery may also result in infection. Continued treatment with
nasal steroid sprays or oral corticosteroids may lower your resistance to sinus
Is the Long-Term Outlook?
With surgical treatment, most symptoms get significantly
better. However, if you’ve lost some sense of smell, it may never return. Even
with surgery, nasal polyps may regrow in up to 15 percent of patients with a
chronic nasal problem.