Nasal Polyps

Thomas S. Higgins, Jr., M.D., M.S.P.H.
www.higgins-sinus.com

Nasal polyps are water-bag-like growths that occasionally develop in the nasal and sinus passages. They are the result of inflammation and are typically not dangerous or cancer-forming masses. They do not usually cause pain unless an underlying infection is present. Allergies, prior bacterial infections, or even sensitivity to aspirin may all play a role in their development. They can be a reason why some people have ongoing or recurrent sinus problems.


Nasal polyps can be many different sizes and will often not cause symptoms until they grow large enough to interfere with the nasal breathing pattern. Polyps may grow in clusters. Those resistant to medical therapy may require removal with surgery.​

Symptoms

Extensive nasal polyps are often associated with severe sinusitis; however, not everyone who suffers with sinusitis will develop polyps. Often you are not aware of these growth because they are so small. Symptoms of nasal polyps can include a runny nose, the loss of taste and smell, excessive snoring, nasal congestion, headaches, and a postnasal drip. Very rarely in people in which nasal polyps cause severe obstruction of the sinuses, there may be complications around the eyes, such as swelling around the eyes or double vision.

Treatment

Nasal polyps causing symptoms such as trouble breathing or pressure should be investigated and treated. Nasal endoscopy is a minor procedure to see the extent and size of the polyps.  CT scan of the sinuses may also be necessary to determine the amount of surrounding sinusitis is present.


Many treatments are available, including antibiotics, corticosteroids, nasal sprays, and allergy medications. Allergy testing and immunotherapy are beneficial for nasal polyps or symptoms related to seasonal or perennial allergies. Sinus surgery may also be helpful if the problem persists. Surgery helps to reduce symptoms, improve quality of life, and assist in maximizing the effectiveness of the medications.


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Differential Diagnoses

Similar conditions can masquerade as nasal polyps. These include:

  • Mucocele: A walled-off sinus cell filled with thick mucus. These lesions can cause severe complications and should be evaluated.

  • Antrochoanal polyp: A single polyp arising from the maxillary sinus from a twisted “stalk” of mucosa.

  • Mucus retention cyst: A benign fluid-filled cyst, often in the maxillary sinus, that tends to not grow.

  • Tumors: Several types of tumors, both benign and cancerous, can arise from the paranasal sinuses. It is, therefore, important for all polyps to evaluated thoroughly. Occasionally, tumors can even arise from within the polyposis. Sinonasal tumors may include inverted papilloma, adenocarcinoma, esthesioneuroblastoma, and others. ​​

Conditions Associated with Nasal Polyps

Some medical conditions can be associated with the development of nasal polyposis.


  • Cystic fibrosis is a genetic disorder of the mucus-producing glands that affects the liver, lungs, kidneys as well as the intestines. Sinus problems commonly develop because mucus cannot drainage appropriately. Severe nasal polyps is common as well as recurrent resistant sinus infections. There is no cure for cystic fibrosis and requires lifelong treatment.

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  • Aspirin Triad is a condition characterized by nasal polyps, asthma, and aspirin sensitivity/intolerance. Nasal polyposis is extensive and is known for being resistant. Avoidance of aspirin is highly recommended in these patient unless desensitization has been performed.


  • Allergic Fungal Sinusitis includes chronic sinusitis with nasal polyps, thick allergic mucin, and fungal colonization within the sinus cavities. It typically presents as one-sided severe polyposis. Interestingly, antifungal medications tend to not help with this condition. The best treatment is typically sinus surgery with removal of all fungal elements and corticosteroid therapy. This treatment can be curative if all the fungal debris is removed.  

"Conditions Associated with Nasal Polyps include
Cystic Fibrosis, Aspirin Triad, and Allergic Fungal Sinusitis."

To see Dr. Thomas Higgins, a fellowship-trained Rhinologist (Sinus Specialist) experienced with Nasal Polyps, click below
or call (502) 894-8441.