Nasal polyps are soft, painless, benign growths lining the sinuses or nose. It may present as unending cold symptoms. Persistent nasal congestion even after taking over-the-counter medications for allergy or cold. Nasal polyps are common among individuals with inflamed nasal passages, repeat infections, allergies, or asthma.
The partial blockage of the sinuses and nasal passages results from irritation and swelling of the nasal polyps. More conditions in adulthood associated with nasal polyps include cystic fibrosis, allergic rhinitis, and chronic rhinosinusitis. Note that nasal polyps occur on both sides. Therefore, growth on one side could indicate different conditions, such as a malignant tumor.
Causes of Nasal Polyps
A change in the mucous membranes lining the sinuses is the cause of polyps’ development. It could be because of the recurrent inflammation of the membranes or persistent chronic inflammation. Fluid accumulation, redness, and swelling are indications of inflammation. In addition, studies have revealed that samples obtained from the nasal polyps contain extra eosinophils, often associated with allergic reactions or infections.
Nasal Polyps Symptoms
Most people may fail to notice that they have nasal polyps because the region lacks nerve sensation. Polyps can grow to the point of blocking the nasal passages, causing chronic congestion. Symptoms associated with sinus polyps include snoring, sleep apnea, pressure sensation in the face or forehead, breathing through the mouth, and a decreased smell sensation.
Patients will also present with nasal stuffiness, post-nasal drip, runny nose, and a feeling of a blocked nose. In the presence of sinus infection in addition to the polyps, the patient may experience headaches or pain.
Diagnosis of Nasal Polyps
The polyps are visible when you look into the nasal passages using a nasoscope or otoscope. In case the polyps are deeper within the sinuses, the physician may prefer endoscopic procedures. It entails the use of a thin and flexible tube having a camera and light on its end.
An MRI scan or a CT scan may be the most suitable to obtain the exact location and size of the polyps. On the scans, polyps appear as opaque spots. Besides, scans will also reveal the effect of polyps on the bone at that site. Thus, it will assist in making the correct diagnosis and ruling out other severe conditions such as malignant growths or deformities.
Physicians may also carry out an allergy test to determine the cause of recurrent nasal inflammation. The test entails pricking the skin and depositing various allergens. The physician will observe any immune response to the allergens. It would be best to carry out a test for genetic conditions like cystic fibrosis in young patients.
Treatment for Nasal Polyps
It is always challenging to manage chronic sinusitis irrespective of whether polyps are present or not. You will collaborate with healthcare professionals to develop a suitable treatment plan for the long-term management of symptoms that may exacerbate inflammation. Treatment aims to eliminate the polyps or reduce their size. Medications are the first-line approach in management.
Nasal Corticosteroids
Your physician may prescribe nasal sprays containing corticosteroids to minimize irritation and swelling. Nasal sprays are capable of eliminating the polyps or shrinking them. Some of the glucocorticoids used in nasal sprays include beclomethasone, triamcinolone, mometasone, budesonide, and fluticasone. Nasal sprays are effective in patients with smaller polyps. However, these agents may be associated with a nosebleed, headache, and sore throat.
Injectable and Oral Corticosteroids
When the nasal sprays are ineffective, your physician may recommend oral corticosteroids such as prednisolone. The tablets may be used alone or in combination with the nasal sprays. However, systemic corticosteroids are associated with severe adverse effects such as elevated blood pressure and fluid retention when taken for an extended period.
It is advisable to take the tablets for a shorter duration. For chronic nasal polyps, the physician may opt for injectable corticosteroids.
If you have chronic sinusitis and nasal polyps co-occurring, your physician may recommend an injection of dupilumab. The drug is effective in lessening congestion and reducing the size of nasal polyps.
There are conditions known to exacerbate preexisting inflammation. Hence, the need to prescribe antihistamines and antibiotics to manage fungal and bacterial allergies. Antihistamines will control allergic reactions.
Note that aspirin desensitization may be necessary under the supervision of a specialist for patients who are highly sensitive to aspirin but have nasal polyps. The desensitization must be carried out in a clinic or hospital setup, and it involves the gradual increase of aspirin dose. Nevertheless, it allows the body to tolerate aspiring for long-term therapy.
Polypectomy
Suppose the medications fail to eliminate or shrink the nasal polyps. In that case, endoscopic surgery may be necessary for removing the polyps and correcting the damage in the sinus that predisposes them to frequent inflammation and polyp development. The surgeon will insert the tube fitted with a tiny camera and a magnetic lens through the nostrils into the sinus cavities during the surgical procedure.
The physician will use tiny instruments to remove the polyps and substances that could disrupt fluid flow from the sinuses. Before the surgical procedure, the patient will be given either a general or local anesthetic to cause a reversible loss of sensation. In addition, it allows the patient to be comfortable during the surgery. During the process, the surgeon may also decide to widen the openings from the sinuses to the nasal passages.
Endoscopic surgery will be carried out as an outpatient technique. After completing the surgery, your physician may recommend nasal spray steroids to prevent the re-occurrence of polyps. The physician can also advise you to use saline water to accelerate healing.
Complications Associated with Nasal Polyps
Surgical treatment of nasal polyps is associated with nosebleeds in some cases. Surgical procedures could also be a risk factor for infection. It is important to note that prolonged use of steroids suppresses the immune system and may lower your resistance to infections.
Hence, the need for the physicians to closely monitor patients on these drugs and prescribe them for the shortest duration possible. With surgical procedures, there is a better outcome. However, it may take longer to recover from the loss of smell sensation.
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