Roheen Raithatha, MD, FACS, FARS
What are Nasal Polyps?
Nasal polyps are soft and painless growths of the lining of the nasal passageway and sinuses. These noncancerous growths resemble grapes and result from chronic inflammation. Nasal polyps are associated with chronic sinusitis, asthma, drug sensitivity (aspirin or non-steroidal anti-inflammatory drugs like ibuprofen), seasonal allergies or several immune disorders. ENT physicians at ENTA can treat nasal polyps and prevent further growth.
Larger growth of nasal polyps can block the nasal passage leading to nasal congestion or can cause facial pressure from blocking the sinuses. It can further lead to a sinus infection, acute breathing problems like an asthma exacerbation, or loss of smell. Nasal polyps are more common in adults; however, they can affect people of any age. They are typically not painful and can be treated with medications (most common topical steroids but sometimes with oral steroids) and surgery; however, nasal polyps can recur even after therapy.
Causes of Nasal Polyps
Nasal polyps grow from the inflamed linings of the nasal and sinus tissue called mucosa, which helps to filter the nose, makes mucus and humidifies the air we breathe in. When a person contracts a nasal/sinus infection or is exposed to an allergen, the mucosa becomes red and swollen. In more severe cases, the mucosal lining becomes so inflamed that it starts to form nasal polyps.
Nasal polyps are commonly triggered by allergic rhinitis or sinus infections. Other less common triggers include Churg-Strauss Syndrome, cystic fibrosis, sensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, immune dysfunction and even genetic reasons. In addition, some patients have no known cause of their nasal polyps.
Symptoms of Nasal Polyps
Nasal polyps most commonly occur in the area where the sinuses (maxillary, ethmoid, frontal, and sphenoid) drain into the nasal passageway. Since polyps lack nerve sensation, the person may not know about the growth of polyps until they grow large enough where they block the nasal passageway leading to nasal congestion, block the sinus drainage pathways leading to facial pressure, or block the olfactory (smell) nerves leading to decreased or even complete loss of smell.
Patients often overlook the symptoms thinking it’s due to a cold or allergies. Common symptoms to look out for include:
- Runny nose
- Nasal congestion/stuffiness
- Reduced or loss of sense of smell
- Postnasal drip
- Facial pressure/pain/headaches
- Mouth breathing
At the first start of noticing symptoms, a patient can book a same day appointment with ENTA at any of their 46 clinical locations.
How to Diagnose and Treat Nasal Polyps
A large nasal polyp can be diagnosed by an ENT specialist or an allergist if it is visible towards the front of the nose by looking with a light. If the polyps are deeper in the nose/sinuses, your ENT physician may need to perform a nasal endoscopy by placing a small camera into the nose to examine higher and deeper in the nose. In addition, a CT scan can help determine the extent of the nasal polyps and which sinuses they are coming from. Allergy testing also helps to determine if there is an allergic or immune cause of the nasal polyps. Nasal polyps can then be treated with a combination of allergy medications, topical/oral steroids, and saline rinses as a starting point. If a patient has a corresponding sinus infection, then antibiotics are used too. If nasal polyps don’t respond to medical therapy then sometimes sinus surgery is needed.