Nasal polyps are benign growths or swellings in the lining of the nasal cavity. Polyps typically narrow the sinus passages, blocking the normal drainage of mucus.
Polyps may occur singly, but they more often appear in clusters in both sides of the nose. They are generally not a serious health threat but may grow large enough or numerous enough to obstruct the airways and cause breathing difficulty. Also, they may block drainage of the sinuses and foster recurrent sinus infections. Nasal polyps usually respond well to treatment, although they tend to recur. Incidence is higher among adults than children.
Persistent nasal polyps may require biopsy, particularly when there is bleeding, as the polyps may harbor a focus of cancer.
WHAT CAUSES NASAL POLYPS?
- Nasal polyps usually result from persistent irritation caused by a chronic allergy (allergic rhinitis), which triggers swelling and fluid retention in the mucous membrane of the nasal cavity.
- Recurrent or persistent nasal and sinus infections increase the risk of developing nasal polyps.
- An allergy to aspirin may underlie the development of nasal polyps.
SYMPTOMS OF NASAL POLYPS
- Feeling of blockage in the nose or sinuses
- Runny nose
- Loss of the sense of smell
- Dull pain or pressure in the face
- Recurrent headaches
- Nasal discharge
- Breathing difficulty
- Prompt and aggressive treatment of nasal allergy or chronic sinusitis may slow nasal polyp development.
- Patient history and physical examination are necessary. The doctor may use a nasal speculum, a device that distends the nostrils to view the nasal cavity.
- CT scan of the sinuses may be performed to show opaque (cloudy) spots where the polyps reside.
- X-rays may be taken of the nasal passages and sinuses.
HOW TO TREAT NASAL POLYPS
- The first line of treatment is the same as for allergies: antihistamines, nasal decongestants, inhaled corticosteroid spray, or allergy shots. These measures are most successful when polyps are small. A dose of oral corticosteroids usually reduces the size of polyps. However, relief is likely to be temporary.
- Antibiotics may be prescribed if an infection is diagnosed.
- The most reliable and long-lasting treatment of polyps is surgical removal (polypectomy). A single polyp may be removed in the doctor’s office with local anesthesia. Multiple polyps are best treated with endoscopy, a procedure using a slender optical viewing tube that can be inserted into the nose.
- In addition to polyp removal, narrow passages in the sinuses are often corrected during the polypectomy in order to permit a more precise and complete excision of the polyp, thereby reducing the likelihood that polyps will recur at the same site.
- After a polypectomy, nasal steroids should be used, even if they were previously ineffective. With the polyps removed, the medication will reach the mucous membrane and is likely to be more effective in reducing the swelling of nasal membranes.
- Over-the-counter pain relievers may be used. A special note: since an allergy to aspirin may be responsible for nasal polyps, people who are prone to polyps should use acetaminophen rather than aspirin.
WHEN TO CALL A DOCTOR
- If you experience symptoms of nasal polyps, make an appointment to see a doctor. You will most likely be referred to an otolaryngologist (ear, nose and throat specialist) for further examination and treatment.
- If you experience persistent or excessive bleeding, high fever, or unrelenting pain after surgical removal of nasal polyps, contact a doctor immediately.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media