Nasal Polyps

What are nasal polyps?
Nasal polyps are soft, fleshy swellings that grow in the nose. They may be yellowish-green or pink in colour. Nasal polyps can become very large in size.

How common are nasal polyps?
Nasal polyps are common, affecting between one and 20 out of every 1,000 people. Men are affected by nasal polyps four times more often than women, and they are prevalent after the age of forty.

What are the causes of nasal polyps?
Certain conditions cause inflammation of the nose or sinuses, leading to the development and formation of polyps. These conditions include:

• Asthma

• Allergic rhinitis

• Cystic fibrosis

• Aspirin sensitivity

• Churg-Strauss syndrome (allergic granulomatous angiitis)

What are the risk factors that contribute to the development of nasal polyps?
Tell your doctor if you have any of the following risk factors:

• Sex: male

• Age: over 40 years

• Aspirin sensitivity

• Asthma that begins in adulthood

• Recurrent sinusitis

What are the symptoms of nasal polyps?

1. The most important symptom is a feeling of nasal blockage. You may find it difficult to breathe through your nose and therefore need to breathe through your mouth most of the time.

2. Runny nose is a predominant symptom.

3. Posterior nasal drip may occur.

4. Loss of the senses of smell and taste.

5. Large nasal polyps cause headaches and snoring.

6. Nasal polyps sometimes interfere with and affect night-time breathing, causing obstructive sleep apnoea.

How are nasal polyps diagnosed?

1. Nasal endoscopy: A thin, flexible tube with a magnifying lighted lens or a small camera allows the doctor to perform a detailed examination inside the nose and sinuses.

2. Imaging: Images can be obtained with computed tomography (CT) or magnetic resonance imaging (MRI), helping the doctor determine the size and location of polyps in the deep areas of your sinuses and assess the extent of inflammation.

3. The doctor may suggest skin tests to determine whether allergies contribute to chronic inflammation.

4. If you have a young child diagnosed with nasal polyps, the doctor may sometimes suggest a test for cystic fibrosis, or any genetic disease that affects the glands that produce mucus, tears, sweat, saliva, and digestive juices.

What are the treatment options for nasal polyps?

• The doctor may prescribe an intranasal steroid spray. This medication shrinks the nasal polyps and reduces inflammation.

• In the case of large polyps or more severe inflammation, steroid tablets may be prescribed either alone or together with a steroid spray.

• Other medications: These include drugs that help treat conditions that may significantly worsen inflammation, such as antihistamines, antibiotics for infections, and antifungal drugs for those with fungal sensitivity.

When is surgical intervention recommended?
Surgical intervention is only resorted to if the nasal polyps are very large or if the patient does not respond well to other treatments. 75% of patients with polyps were found to have nasal polyps reappear again 4 years after surgical removal.

Different surgical procedures:

1. Polypectomy: This is the most common procedure for removing nasal polyps. The patient is given either local or general anaesthesia. Sometimes the surgeon removes a small piece of bone from the nose to reduce the risk of recurrence.

2. Endoscopic sinus surgery: This procedure is used especially for large nasal polyps or when they pose a risk to the sinuses. A long, thin tube with a video camera is inserted into the patient’s nose and sinuses. Small incisions are made on the patient’s face, through which surgical instruments are inserted to remove the polyps and open the sinus cavities.