Soft, teardrop-shaped growths often located where the sinuses meet the nasal cavity are called nasal polyps.
Usually painless, these growths are also typically non-cancerous (benign) and frequently associated with allergies or asthma. It’s possible to have nasal polyps with no symptoms at all, in which only periodic monitoring may be necessary.
It’s when sinus drainage is affected and symptoms become disruptive that a referral may be made to an ear, nose, and throat specialist to determine the most appropriate treatment.
Causes of Nasal Polyps
It’s known that inflammation contributes to the formation of nasal polyps. However, it’s not clear why some people are affected by these growths and others are not. There’s some evidence suggesting that people with nasal polyps may have an immune system that responds differently to some chemical markers.
Symptoms and Risk Factors
In addition to sneezing, having a runny nose, and postnasal drip, individuals with nasal polyps large enough to contribute to symptoms often have difficulty smelling. Symptoms may also include sensitivity to irritants like dust, fumes, and certain odors, wheezing, sinus infections, and headaches or facial pain. Some people have a feeling of persistent stuffiness, while others may have upper teeth pain. Snoring is also sometimes linked to nasal polyps. Risk factors associated with nasal polyps include:
- Having sinusitis or asthma
- Being sensitive to aspirin
- Having a disease that causes inflammation of blood vessels (Churg-Strauss syndrome)
Diagnosis of Nasal Polyps
An ear, nose, and throat doctor may perform a nasal endoscopy to view the nasal passageways and nasal cavity. A CT scan is sometimes performed to rule out other reasons for a nasal blockage or obstruction. Allergy tests might be done to determine if allergies could be contributing to the swelling of nasal passageways or sinus cavities.
If chronic sinusitis is experienced with nasal polyps, treatment typically involves using nasal sprays or solutions to reduce drainage problems and remove irritants from the affected area. Medication is usually recommended as a first attempt at treating nasal polyps. The goal is to either eliminate them altogether or reduce their size. Treatment and/or symptom management efforts may also include:
- Nasal corticosteroids (nasal sprays)
- Corticosteroids given orally or as injections if nasal sprays aren’t effective, or if symptoms are severe
- Antihistamines to treat allergies that may be contributing to symptoms
- Antibiotics to treat chronic infections
- Aspirin desensitization for patients with aspirin sensitivity that may be affecting symptoms or inhibiting treatment attempts
Surgery for Nasal Polyps
Surgery may become an option if attempts to shrink the polyps or manage symptoms with medication are unsuccessful. Endoscopic surgery is usually performed by inserting a small, lighted tube with an attached camera and magnifying lens through the nostrils to the sinus cavities. In addition to removing the polyps, an ENT doctor may enlarge the opening around nasal passageways and sinuses. Corticosteroid nasal spray may be used following surgery to prevent nasal polyps from returning.
Anyone can develop nasal polyps, although these growths are more likely to be an issue for adults 40 and over. If polyps in nasal passageways develop before the age of 10, patients are often checked for cystic fibrosis. Men are also twice as likely to have problems with nasal polyps than women. The risk of experiencing polyps or recurrence after treatment may be reduced by managing asthma and allergy symptoms. It may also be beneficial to use a humidifier at home, perform nasal rinses, and avoid airborne nasal irritants as much as possible.