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Nasal Polyps: Soft and harmless growths in the nasal passage

Nasal polyps are soft, fleshy, non-cancerous growths that develop inside the passages of the nose and sinuses. They develop from the layer of cells that are covering these passages and hang like tear-drops or grapes.

Nasal polyps are more common in young and middle age, but they can develop at any age.

Nasal polyps

Causes and risk factors

Causes

Nasal polyps are thought to develop because of long-standing irritation and swelling (inflammation) of the cells in the nasal passage due to allergies, asthma, repeated infections, drug sensitivity or some immune disorders. The covering layer of nasal passage gradually swells and hangs down.

Risk Factors

The conditions which increase the likelihood of getting polyps include:

  • Allergy (hay fever)
  • Asthma
  • Chronic sinus infections
  • Cystic fibrosis
  • Aspirin sensitivity

Symptoms and signs

You may not realise that you have nasal polyps as they may not cause any symptoms and may not be seen by you. Small polyps may not give rise to any symptoms. Larger polyps can cause different symptoms due to the blockage of the air passages such as:

  • Blocked nose – You may feel that your nose has become stuffy, making it difficult to breathe through the blocked nostril.
  • Running nose
  • Post-nasal drip – dripping of mucus on the back side of the nose that trickles down the throat.
  • Decreased smell sensation
  • Feeling of fullness or pressure in the face
  • Snoring caused by the blockage in the nose
  • Sinusitis – If the polyp blocks the opening of sinuses, fluids do not drain from the sinuses and infection of sinuses can develop.

nasal polyps

Diagnosis

If you suspect you have a polyp based on your symptoms, you need to consult an ENT specialist. Your doctor will be able to diagnose the polyps by your symptoms and examination of the nose.

You may be asked to undergo a few tests that help in confirming the diagnosis, look for complications and assist in planning the treatment. These include:

  • Scans: The images obtained from computerised tomography (CT) or magnetic resonance imaging (MRI) scans can help in locating the site and size of the polyp, health of the sinuses and rule out other causes of nasal obstruction.
  • X-rays: X-ray of the head region usually do not show the polyps, but can show the nasal passages and the health of the sinuses.
  • Nasal endoscopy: A flexible tube with a light and a small camera (called nasal endoscope) is inserted into the nose to look at the nasal passages and sinuses.
  • Allergy testing: In some cases, especially if you are getting polyps repeatedly, your doctor may advise skin prick tests to find out what allergies you have.

Treatment and prevention

Treatment

Medications

Your doctor may prescribe drugs which can make the polyps shrink. These medications include:

Nasal corticosteroids: Corticosteroid drops or sprays applied inside the nose may shrink the polyps when used for some weeks or months.

Oral corticosteroids: Corticosteroid tablets may be given in some cases, but they are prescribed for a short duration due to their side effects when used for long.

Other medicines: Antibiotics may be given in those who have sinusitis. Antiallergic medicines may be given to prevent polyps from growing back.

Surgery

If medicines do not shrink or eradicate the nasal polyps, you may require an endoscopic surgery to remove the polyps. The doctor passes a narrow tube with camera and instruments into the nose and removes the polyps. 

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Complications

Some of the complications that can be caused by the nasal polyps include:

  • Sinusitis: Nasal polyps can increase the likelihood of getting sinus infections.
  • Asthma flare-ups: Asthma attacks can be activated by chronic rhinosinusitis.
  • Obstructive sleep apnea: Nose blocks can cause this serious condition in which the breathing can stop and start suddenly during sleep.
  • Recurrence of polyps: Polyps may come back after treatment.

Next Steps

See an ENT specialist if you have symptoms suggestive of nasal polyps. Many of the symptoms of nasal polyps are similar to that of chronic sinusitis, but if these symptoms last more than 10 days consult a doctor.

Red flags

Seek immediate medical attention if you have:

  • Severe breathing difficulty
  • Swelling around eyes
  • Double vision, decreased vision or difficulty moving the eyes
  • A severe headache that increases on bending the head
  • Severe symptoms with fever

Consult a top Ear-Nose-Throat (ENT) Specialist

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References

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NHS choices. Nasal polyps. Accessed at http://www.nhs.uk/Conditions/Polyps-nose/Pages/Introduction.aspx US National Library of medicine.

Medical Encyclopedia -Nasal polyps. Accessed at https://www.nlm.nih.gov/medlineplus/ency/article/001641.htm

Nasal polyps. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/ear_nose_and_throat_disorders/nose_and_paranasal_sinus_disorders/nasal_polyps.html.

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