Nasal Polyps

Nasal polyps are soft, painless, non-cancerous growths that form in the nose or sinuses around the area where the sinuses open into the nasal cavity. They are quite common, and can form at any age but are more likely seen in young and middle-aged adults.

Your risk of developing nasal polyps increases with any condition that triggers chronic inflammation in your nasal passages or sinuses. Some of those conditions may include asthma, recurring infections (e.g., chronic sinusitis), allergies (e.g., airborne fungi), drug sensitivity (e.g., aspirin), or certain immune disorders. Family history may also play a role, as certain genetic variations associated with immune system function make you more likely to develop nasal polyps.

Usually, small nasal polyps don’t cause symptoms; however, larger growths can block your nasal passages and sinuses leading to breathing problems, a lost sense of smell, and frequent infections.

For patients who already have chronic sinusitis, the addition of nasal polyps may cause sinusitis symptoms, such as these, to worsen:  

• A runny nose
• Persistent stuffiness
• Postnasal drip
• Decreased or absent sense of smell
• Loss of sense of taste
• Facial pain or a headache
• Pain in your upper teeth
• A sense of pressure over your forehead and face
• Snoring

If your sinusitis symptoms do worsen, you should seek immediate emergency care or call 911, especially if you are experiencing any of the following:

• Serious trouble breathing
• Sudden worsening of symptoms
• Double vision, reduced vision or limited ability to move your eyes
• Severe swelling around your eyes
• Increased headache pain, high fever or inability to tip your head forward

Nasal polyps can cause complications, because they block normal airflow and fluid drainage, and because your system is in a chronic state of inflammation. Some potential complications that could occur include obstructive sleep apnea, asthma flare-ups (chronic rhinosinusitis can aggravate asthma), and sinus infections (nasal polyps make you more susceptible to sinus infections).

During a consultation, your ENT (ear, nose, and throat) doctor will conduct a general physical exam and an examination of your nose. Your doctor may use a lighted, nasal endoscope to look into your nose and sinuses. Additional testing, such as allergy testing (e.g, skin prick test or blood test) and imaging studies (e.g., CT scan or MRI) can help your doctor determine the cause and or pinpoint the size and location of polyps in deeper areas of your sinuses. This testing will also help to figure out the extent of your inflammation.

Your treatment options will depend on the severity of your symptoms and the source of your chronic inflammation. If allergies are the source of your inflammation, for example, your doctor may take a medical management approach.    

Medical Management

Ideally, the goal of treatment is to reduce the size of the polyps or eliminate them altogether. Your doctor may, therefore, recommend medications, such as the following, to manage your symptoms. 

Antibiotics. These may be prescribed to treat chronic or recurrent infections.

Antihistamines. These are prescribed to treat allergies that contribute to chronic inflammation in your sinuses or nasal passages.  

Nasal corticosteroids.  Corticosteroid nasal sprays help to reduce inflammation. Treatment may help shrink the polyps or eliminate them completely.

Oral and injectable corticosteroids.  An oral corticosteroid, such as prednisone, may be prescribed in combination with nasal corticosteroids or for patients who don’t respond to nasal corticosteroids. As a precaution, they are only prescribed for a short time period due to side effects.

Surgical Management

If medical management of your symptoms is unsuccessful, your doctor may recommend endoscopic sinus surgery to remove polyps and to correct problems with your sinuses that make them prone to inflammation and polyp development.

Endoscopic sinus surgery is usually performed as an outpatient procedure. During surgery, your surgeon inserts a small tube with a magnifying lens or tiny camera (endoscope) into your nostrils and guides it into your sinus cavities. Tiny instruments are then used to remove polyps and other obstructions that block the flow of fluids from your sinuses. 

After surgery, your doctor may prescribe a nasal corticosteroid spray to help prevent the recurrence of nasal polyps. You may also be advised to use a nasal saline rinse to promote healing after surgery.

It should be noted that no matter the treatment, nasal polyps can return. That is why it is important to determine the cause of your chronic inflammation so that we can help prevent nasal polyps from returning.

If your chronic sinusitis symptoms have gotten worse, it may be due to nasal polyps. Contact Integrated ENT of Lone Tree at (303) 706-1616 to set up a consultation for diagnosis and treatment recommendations.