Treating Nasal and Sinus Polyps

Rhinosinusitis refers to an inflammation of the tissues of the nose (rhino-) and sinuses. Polyps, tissue swellings that can form within the nose and sinuses, can be responsible for many of the symptoms described by patients with rhinosinusitis.

Polyps may simply block the nasal airway, making it difficult to breath through the nose; or they may block the proper drainage of the sinus cavities, leading to stagnant secretions that may become infected.

Polyps are generally thought to occur as a result of an ongoing inflammatory process within the nose and sinuses. Although the inflammatory process might be related to allergies, most cases of polyps occur as a result of non-allergic processes.

hns_07_0Whatever the cause, polyps can make patients miserable. Common symptoms in patients with nasal and sinus polyps include nasal obstruction, decreased sense of smell, recurrent sinus infections and profuse nasal drainage. Many of these patients feel as though they have a cold all of the time.

If polyps are suspected, the patient may undergo an endoscopic examination in the clinic. This procedure uses a small telescope that is placed inside of the nostril to examine the nose and sinuses. Computed tomography (often called CT or CAT scans) may help to delineate the precise location of polyps within these cavities.

After establishing the appropriate diagnosis, multiple medical treatments may be initiated. Medications include anti-inflammatory sprays, decongestants, inflammatory mediator inhibitors, and systemic steroid medications. It is important that the physician and patient recognize that medications are often needed on a long-term basis in order to reduce polyp size and prevent their re-growth.

In some cases, surgical excision of the polyps is required, using the endoscope to visualize the polyps. Following this type of surgery, it is critical to maintain medical treatment and closely observe the nose and sinus cavities to prevent recurrence of any polyps. In many cases, if a proper medical and surgical treatment plan is carefully followed, patients will not require further polyp removal surgery.

Definition

Nasal polyps are small, sac-like growths consisting of inflamed nasal mucosa.

Causes, incidence, and risk factors

Nasal polyps appear in a number of conditions. The polyps originate near the ethmoid sinuses (located at the top of the nose) and grow into the open areas.

Large polyps can obstruct the airway

Children with nasal polyps sound congested and often breathe through their mouths because of chronic nasal obstruction. A runny nose or infected nose is common.
Polyps are seen with asthma, allergic rhinitis (hay fever), chronic sinus infections, and cystic fibrosis. About 1 in 4 people with cystic fibrosis have nasal polyps.

Symptoms

  • Nasal obstruction
  • Mouth breathing
  • Voice — sounds as if person is congested

Having any of the following conditions indicate a susceptibility to nasal polyps:

  • Asthma
  • Hay Fever
  • Sinus infection
  • Cystic fibrosis

Signs and tests

Nasal examination reveals a grayish grape-like mass within the nasal cavity.

Treatment

Surgery to remove the polyps is recommended.

Expectations (prognosis)

Surgical removal usually allows easier breathing through the nose.

Complications

  • Infection
  • Bleeding

Nasal polyps may recur.

Calling Your Health Care Provider

Call for an appointment with your health care provider if you have persistent difficulty breathing through your nose.

Prevention

There is no known prevention.