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Nasal Polyp

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(Nasal Polyposis)

Definition

Nasal polyps are growths that develop on the inside of your nose or sinuses. They are not able to spread to other parts of the body. You may have a single nasal polyp or you may have several. Nasal polyps are soft and pearl-colored. They can be treated.
Nasal Polyps
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Causes

Doctors do not know the cause of nasal polyps. Several factors may contribute to nasal polyps, including:

Risk Factors

Factors that can increase your chance of developing nasal polyps include:
  • Gender: males
  • Age: older than 40
  • Aspirin sensitivity or allergy
  • Asthma
  • Churg-Strauss syndrome—a rare disease that inflames the blood vessels
  • Cystic fibrosis
  • Hay fever or other respiratory allergies
  • Frequent sinus infections

Symptoms

Very small nasal polyps may not cause any symptoms. Larger polyps may block the nose, making it difficult to breathe through the nose. They can also block the passage of odors and reduce the sense of smell.
If you have any of these symptoms do not assume it is due to nasal polyps. These symptoms may be caused by other conditions. :
  • Mouth breathing
  • A runny nose
  • Constant stuffiness
  • Loss or reduction of sense of smell or taste
  • Dull headaches
  • Snoring
  • Frequent nosebleeds

Diagnosis

It is important to see a doctor with special training in diagnosing and treating nasal polyps, called an otorhinolaryngologists or an otolaryngologist. Your doctor can refer you to a specialist.
The doctor will look at the inside of your nose to check for blockage. This physical exam may include:
  • Putting cotton balls soaked in medicine inside your nose to reduce swelling or spraying the inside of your nose with an anesthetic medicine
  • Using a small instrument to look inside the nose
  • Gently pressing inside of the nose to check for swelling
The doctor will ask questions about:
  • Your medicines
  • Your personal and family medical history, including any allergies
Other tests may be done to reach a diagnosis.
Pictures may be taken of your nose. This can be done with a CT scan .
Your bodily fluids and tissues may be tested. This can be done with:
  • Sweat test
  • Allergy skin tests
  • Biopsy of the polyp

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Medications

  • Nasal sprays, particularly those containing steroids, to reduce swelling, increase nasal airflow, and help shrink polyps
  • Drugs to help reduce swelling and shrink polyps
  • Drugs to control allergies or infection, such as antihistamines for allergies or antibiotics for a bacterial infection

Surgery

  • Polypectomy—removing nasal polyps. If the polyps are small, this can be done in your doctor's office. Unfortunately, polyps often return.
  • Endoscopic sinus surgery—removing the nasal polyps and opening the sinuses where the polyps form

Prevention

There are no guidelines for preventing nasal polyps because the cause is unknown. But, there are several things you can do to reduce your chance of developing nasal polyps:
  • For a stuffy or runny nose, use a preservative-free saline spray. This helps reduce irritation in the sinuses.
  • If you have hay fever or another allergy, see your doctor for treatment. Avoid the substance that causes your allergy.
  • If you have asthma or frequent sinus infections, take your medicine as your doctor suggests.
  • If you have aspirin sensitivity, avoid all medicines that contain aspirin.

RESOURCES

American Academy of Allergy, Asthma, and Immunology http://www.aaaai.org

American Academy of Otolaryngology, Head and Neck Surgery http://www.entnet.org

CANADIAN RESOURCES

Allergy Asthma Information Association http://aaia.ca

Health Canada http://www.hc-sc.gc.ca

References

Adkinson N, Middleton E. Middleton's Allergy: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2003.

Cummings CW. Otolayrngology: Head and Neck Surgery. 4th ed. St. Louis, MO: Mosby; 2005.

Dalziel K, Stein K, Round A, Garside R, Royle P. Systematic review of endoscopic sinus surgery for nasal polyps. Health Technol Assess. 2003;7:1-159.

Larsen K. The clinical relationship of nasal polyps to asthma. Allergy Asthma Proc . 1996;17:243-249.

Lund VJ. Diagnosis and treatment of nasal polyps. BMJ. 1995;311:1411-1414.

Nasal polyps. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated March 4, 2013. Accessed April 2, 2013.

Patient UK. Nasal polyps. Patient UK website. Available at: http://www.patient.co.uk/health/Nasal-Polyps.htm . Updated March 25, 2011. Accessed April 2, 2013.

White AA, Stevenson DD. Aspirin-exacerbated respiratory disease: update on pathogenesis and desensitization. Semin Respir Crit Care Med . 2012 Dec;33(6):588-94.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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