Nasal Polyps

Nasal polyps are teardrop-shaped, noncancerous growths on the lining of your nasal passages or sinuses. Nasal polyps are associated with chronic inflammation of the lining of your nasal passages and chronic sinusitis. Sometimes, the nasal polyps may be due to a benign (non cancerous) tumor and on very rare occasion, it may be malignant (cancerous).  These nasal polyps tend to obstruct the outflow tract of the sinuses resulting in acute and chronic sinusitis.

 

nasal polyp big grape

Nasoendoscopic photos of benign inflammation polyps as a result of chronic rhinosinusitis in the nasal cavities

nasal polyps seen on CT

Symptoms of Nasal Polyps

Small nasal polyps may cause no problems and go unnoticed. Larger nasal polyps can block your nasal passages or sinuses, you may experience some of the following signs and symptoms:

  • Breathing difficulty
  • Running nose
  • Loss of sense of smell
  • Loss of sense of taste
  • Frequent sinus infections
  • Postnasal drip
  • Facial pain
  • Itching around the eye areas

 

Although nasal polyps can affect anyone, they’re more common in adults, particularly those with asthma, frequent sinus infections and allergies. We have two groups of nasal polyps- antrochoanal and ethmoidal polyps.  Antrochoanal polyps occur in the maxillary sinuses. Ethmoidal polyps occur in the ethmoidal sinuses. The most common type of nasal polyp is ethmoidal polyps.

Some of the signs and symptoms of nasal polyps are similar to many other conditions, including the common cold. If the condition continues for more than 10 days, it is advisable to consult the doctor.

Children with cystic fibrosis often develop nasal polyps.

 

How to diagnose nasal polyps

A diagnosis will typically be made based on your symptoms and a flexible nasal endoscope – a narrow telescope with a camera attached – is also used to examine the nasal cavity and nasopharynx to determine the extent and location of the polyps.

 

 

In some cases, a computerised tomography (CT) scan may be necessary to detect the nasal polyps. The results of the scan can also help to ensure that the growth is not something more serious.

 

 

Causes of Nasal Polyps

The exact cause of nasal polyps is unknown although allergy, chronic infection and abnormal nose lining function have been associated with the formation.

Polyps are an end result of varying disease processes in the nasal cavities. Nasal polyps are associated with chronic inflammation of the lining of your nasal passages and chronic sinusitis. They are also more commonly found in people with health problems like

  • Asthma
  • Chronic sinus infections
  • Cystic fibrosis
  • Allergic rhinitis

 

Treatment for Nasal Polyps

The management of nasal polyps is complex and will depend on many factors.

Medications

  • Oral corticosteroids are the most effective short term treatment in shrinking nasal polyps but they are not meant for long term use. They can give serious side effects if given at high doses and for long duration.
  • USA FDA has recently approved Dupilumab for the treatment of nasal polyps with chronic rhinosinusitis
  • Steroid sprays may shrink reduce the growth of small nasal polyps, but they are relatively ineffective in massive nasal polyposis.
  • Antibiotics have anti-inflammatory properties which may help with inflammation and reducing the size of the nasal polyps.

Surgery

In cases where medication is ineffective, surgery may be recommended. It is an endoscopic surgery is a minimally invasive surgery done through the nose without any external cuts on the nose or face. It is safe and the outcome is good.  although in 10-15% of patients, their nasal polyps do recur despite ‘perfect’ surgical results. This is due to the underlying inflammation that caused these polyps to form in the first place.

Surgery is performed though a computer imaging guidance system (IGS) with video attachment to the endoscope that allows the surgeon to look at a video monitor while operating. The surgeon can spend a longer time on the operation with increased safety and better outcomes for the patient.

Diseased & abnormal tissues such as nasal polyps within the sinuses can use safely removed.

 

 

There is minimal discomfort to the patient and the procedure is usually done under general anaethesia as a day surgery where overnight stay in the hospital is not required.

Some of the signs and symptoms of nasal polyps are similar to many other conditions, including the common cold. If the condition continues for more than 10 days, it is advisable to consult the doctor.

 

Video Explanations

  1. Understand why your nose & sinus is blocked

In this video, Dr Kevin Soh reveals the different causes for block nose. He illustrates with interesting graphics and videos. Understand deviated nasal septum, nasal polyps, enlarged adenoids.

2.  How to get rid of Fungus in Your Sinus

In this video, Dr Kevin Soh describes what is fungus sinusitis and how it can cause nose polyps.  Learn how surgeons approach the maxillary sinus.

 

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