Nasal Polyps
Get expert treatment from an internationally recognized doctor on nasal polyps.
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.
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.
Other Diagnoses to Consider
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.
Condition 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.
- 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.
Diagnostic Tests for Nasal Polyps
Nasal polyps can be a part of airway inflammation, being associated with asthma, allergic rhinitis, and other allergy conditions. Some people have aspirin or NSAID sensitivity, suffering from a condition called Aspirin Exacerbated Respiratory Disease (AERD). Laboratory tests, such as levels of eosinophils or IgE, can be helpful in characterizing the condition. Allergy testing may help determine if concomitant allergies are present.
Nasal polyps are often a sign of more extensive inflammation deeper in the sinus, termed chronic rhinosinusitis. Symptoms, such as trouble breathing, facial pressure, and smell loss can occur.
A diagnostic nasal endoscopy is a minor office procedure that can be performed to see the extent and size of the polyps, determine if infection is present, and evaluate the nose and sinus anatomy for issues, such as a deviated nasal septum or inferior turbinate hypertrophy.
A CT scan of the sinuses, a quick imaging study, may also be necessary to determine the amount of surrounding sinusitis is present and evaluate the paranasal sinus anatomy.
Nasal polyps are often a sign of more extensive inflammation deeper in the sinus, termed chronic rhinosinusitis. Symptoms, such as trouble breathing, facial pressure, and smell loss can occur.
A diagnostic nasal endoscopy is a minor office procedure that can be performed to see the extent and size of the polyps, determine if infection is present, and evaluate the nose and sinus anatomy for issues, such as a deviated nasal septum or inferior turbinate hypertrophy.
A CT scan of the sinuses, a quick imaging study, may also be necessary to determine the amount of surrounding sinusitis is present and evaluate the paranasal sinus anatomy.
Treatment Options for Nasal Polyps
The treatment is tailored to the patient's individual issues. Many treatments are available, including antibiotics for associated infections, oral corticosteroids to temporarily control inflammation, nasal sprays for chronic rhinitis (such as Flonase, Nasacort, and Nasonex), and other allergy medications. Allergy immunotherapy (whether it is SCIT-subcutaneous immunotherapy or SLIT - sublingual immunotherapy) may be beneficial for nasal polyps or symptoms related to seasonal or perennial allergies.
Functional endoscopic sinus surgery (FESS) is a highly successful treatment option that can provide profound symptom relief immediately after surgery. Surgery helps to reduce symptoms, improve quality of life, and assist in maximizing the effectiveness of the medications.
Maintenance medications are important to keeping inflammation under control, with or without, and before and after, sinus surgery. Topical treatment options include steroid sinus rinses (most commonly budesonide sinus rinses) and XHance, an exhalation delivery device that can spray steroid up around the areas where nasal polyps arise. Aspirin desensitization can be considered for those with AERD. Monoclonal antibodies (or "biologics") are also an important add-on treatment option for patients with intense type 2 inflammation and chronic rhinosinusitis with nasal polyps. The current biologics available for nasal polyps include Dupixent, Xolair, and Nucala.
Functional endoscopic sinus surgery (FESS) is a highly successful treatment option that can provide profound symptom relief immediately after surgery. Surgery helps to reduce symptoms, improve quality of life, and assist in maximizing the effectiveness of the medications.
Maintenance medications are important to keeping inflammation under control, with or without, and before and after, sinus surgery. Topical treatment options include steroid sinus rinses (most commonly budesonide sinus rinses) and XHance, an exhalation delivery device that can spray steroid up around the areas where nasal polyps arise. Aspirin desensitization can be considered for those with AERD. Monoclonal antibodies (or "biologics") are also an important add-on treatment option for patients with intense type 2 inflammation and chronic rhinosinusitis with nasal polyps. The current biologics available for nasal polyps include Dupixent, Xolair, and Nucala.
Get the Right Treatment for Your Nasal Polyps
With so many treatment options for nasal polyps, it is important to see a specialist who has extensive experience in treating this condition. Dr. Thomas Higgins, MD, MSPH has subspecialty training from Johns Hopkins Medical institutions and is an international expert on chronic rhinosinusitis with nasal polyps.
To see Dr. Thomas Higgins, a fellowship-trained Rhinologist (Sinus Specialist) experienced with Nasal Polyps, click below
or call (502) 894-8441.
or call (502) 894-8441.