Nasal polyps are teardrop-shaped growths that usually start in the sinus cavity and extend into the nose. There is no relationship between nasal polyps and polyps in the colon. Small nasal polyps often cause no symptoms and go unnoticed, while larger ones can completely block the nasal passages. Although their origin is not really known, they most often begin in patients who have chronically inflamed sinuses. We do know that somewhere between 30% and 50% of patients with nasal polyps have positive skin tests to allergens, indicating that allergy may be a contributing cause in a large subset of patients.
Nasal polyps are more likely to occur in adults, patients with asthma, patients with allergic-like reactions to aspirin and other nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), and people with a family history of nasal polyps. Polyps are extremely uncommon in children unless cystic fibrosis is present. The most common symptoms of nasal polyps are nasal discharge (often thick in consistency and yellow in color), nasal stuffiness, loss of taste and smell, postnasal drip, facial pain, and snoring. Of all these symptoms, the one that is most suggestive that polyps are present is the reduction in taste and smell.
Diagnosis of nasal polyps is usually made when your physician can see the polyp during a routine nasal examination. However, once polyps are suspected, more in-depth examinations will often be made, including nasal endoscopy (by an otolaryngologist or allergist) or CT scanning of the sinuses. When polyps are left untreated, they place patients at risk for frequent sinus infections, obstructive sleep apnea, and, in the most severe cases, changes in facial structure (such as a widening of the bridge of the nose). Treatment of nasal polyps almost always includes intranasal steroids. This treatment may shrink the polyps or eliminate them completely. How-ever, if a nasal corticosteroid is not effective, your doctor may prescribe a short (5 to 10 days) course of an oral corticosteroid, such as prednisone, either alone or in combination with an intranasal steroid spray.
Your doctor may also prescribe other drugs to treat conditions that con-tribute to chronic inflammation in your sinuses or nasal passages, such as antihistamines to treat allergies, antibiotics to treat a chronic or recurring infection, or antifungal medications to treat symptoms of fungal infection. If drug treatment does not shrink or eliminate your nasal polyps, your doctor may recommend surgery. The type of surgery depends on the size, number, and location of the polyps.
For small polyps, many physicians will opt to perform a polypectomy (excision of the polyp), which is usually an office procedure. For more extensive cases, particularly when there is a large amount of chronic sinus inflammation, endoscopic sinus surgery may be recommended. After surgery, you will likely use an intranasal steroid to help prevent the recurrence of nasal polyps. In addition, if you have significant allergies, allergy vaccine treatment may be beneficial in control-ling the concomitant symptoms of allergy.
Nasal polyp
A growth that usually originates in the mucous membrane of the sinus cavity and extends into the nose.