Nasal polyps: no nonsense
Nasal polyps are growths of tissue that grow inside the nose and sinuses. Though not necessarily cause for concern, issues can arise without treatment. In this article, a consultant ENT surgeon explains how nasal polyps form, what the risks are, and what treatment options patients can consider.
What are nasal polyps?
Nasal polyps form on the mucosa, the thin tissue that lines the nasal passages and the sinus cavity. The purpose of the mucosa is to aid the immune system in filtering out foreign particles and keep the respiratory pathways moist, which helps with scent processing. Polyps are noncancerous and usually develop in both sides of the nose. They are typically oval or teardrop-shaped when initially growing, but advanced polyps can become rounder.
Nasal polyps are very common, with around 30 per cent of people having at least a couple. They affect everyone regardless of age, gender, or race, though they are more frequently found in men.
There is no one clear reason for nasal polyps forming, but it is thought to be related to prolonged inflammation of the mucosa tissue. Those who have chronic sinusitis (inflammation for over three months) are most likely to have polyps form – this includes people with allergies, asthma, and recurrent infections.
What are the effects of nasal polyps?
A few small polyps in the nose should not be any reason to worry, but there is no guarantee that they won’t grow or multiply further. Nasal polyps start to become an issue when it causes the patient to develop the following symptoms:
- Congestion
- Runny nose
- Headaches
- Nosebleeds
- Postnasal drip
- Sinus pressure
- Snoring
- Loss of sensitivity of taste or smell
Particularly large polyps can majorly obstruct the nasal passages and sinuses, which can lead to asthma attacks, sinusitis, and significant difficulty breathing.
How are nasal polyps treated?
Patients should be aware that nasal polyps have a strong tendency to recur, especially once treatment stops.
The treatment options for nasal polyps include a medicinal approach and surgery.
Medications used to treat nasal polyps consist of a combination of corticosteroid nose sprays, antibiotics, and antihistamines – the goal is to reduce inflammation and shrink the polyps. It is very unlikely that the medication will get rid of the polyps entirely, but it is not impossible; patients will start to see the results of the medication within two weeks of starting treatment.
When the medicinal approach doesn’t work – and it doesn’t for about a third of patients – then surgery is considered. This is typically minimally invasive and performed with an endoscope, which is a camera and light that is mounted on a thin, flexible arm that allows surgeons to see clearly into the nasal and sinus cavities without the need of incisions. There are several surgical techniques used to circumvent or excise the polyps, such as:
- Polypectomy, where the polyps are simply cut out of the mucosa.
- Balloon sinuplasty, where a balloon is passed through the nasal passages and into the sinus cavity and then inflated to clear the way for airflow.
- Functional endoscopic sinus surgery (FESS), where the polyps and any other obstructive or diseased tissue and structures are removed.
Medication is often prescribed again after surgery to try and prevent recurrence.