How to Tell if You Have Nasal Polyps
Nasal polyps are benign growths that develop in the lining of the nose. Nasal polyps symptoms can include an obstructed nasal passage if they become too big, potentially causing complications such as infections, breathing difficulties and a loss of smell.
Nasal polyps are a common condition that affects up to 4% of people worldwide, though they are usually associated with chronic inflammation. As a result, they are most frequently diagnosed in people with asthma, chronic rhinosinusitis, cystic fibrosis and aspirin-exacerbated respiratory disease (AERD). However, anyone can get nasal polyps, and learning how to recognize the symptoms as soon as they arise is key for quick and effective treatment.
What Are Nasal Polyps?
Nasal polyps are soft, painless, fleshy growths that develop in the lining (mucosa) of the nose. They may be yellow-brown, grayish or pink in color, with a teardrop shape. They may grow in one or both nostrils (either singly or in clusters).
The polyps themselves are harmless and, if they are small in size, don’t cause any symptoms. In fact, many people with nasal polyps don’t even know they have them! If the polyps grow too big however, they can block the nasal passages and cause chronic congestion. This can lead to breathing problems, discomfort and even a loss of smell if left untreated.
What Causes Nasal Polyps?
Nasal polyps are associated with chronic inflammation of the mucosa — in other words, long-term irritation and swelling of the lining of the nasal cavities. As a result, they are most often seen in people with persistent asthma, cystic fibrosis, aspirin-exacerbated respiratory disease (AERD) and chronic rhinosinusitis (CRS). Recurrent infections, aspirin sensitivity, allergies and foreign objects that become lodged in the nose are also factors that can increase the risk of developing nasal polyps. Though they can affect anyone, they are far more common in adults than children.
What Are the Different Symptoms of Nasal Polyps?
Nasal polyps are soft and painless, so they usually don’t cause any symptoms when small. As they start to grow, however, they can block the nasal cavities and cause chronic congestion, leading to symptoms such as:
- A persistently blocked or stuffy sensation in the nose
- Difficulty breathing through the nose
- A runny nose
- Postnasal drip (this is where mucus runs down the back of the throat)
- A feeling of pressure and/or pain in the forehead and/or face
- Pain in the upper teeth
- Reduced or lost sense of taste
- Reduced or lost sense of smell
- Frequent nosebleeds
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Who Is Most at Risk of Getting Nasal Polyps?
Anyone can get nasal polyps, but they are usually associated with chronic inflammation. Therefore, the people most at risk of developing nasal polyps are:
- People with asthma
- People with allergies to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- People with chronic pollen allergies (AKA chronic rhinitis)
- People with chronic rhinosinusitis (CRS)
- People with cystic fibrosis
Nasal polyps usually affect adults. However, they are also common in children with cystic fibrosis.
How Are Nasal Polyps Diagnosed?
If you think you may have nasal polyps, you should go and see a — especially if you are experiencing difficulty breathing or a reduced sense of smell. Nasal polyps are diagnosed with a simple visual exam, in which the doctor will look inside your nose.
Treatment Options for Nasal Polyps
The symptoms caused by nasal polyps cannot be addressed until the polyps are removed. The first line of treatment usually involves medication, in which topical medications are sprayed into the nose to shrink the polyps. If this does not work, surgery may be necessary to remove the polyps.
Medication Treatment for Nasal Polyps
Often, the first treatment option for nasal polyps is topical medication. These are usually steroids (such as fluticasone, budesonide or mometasone), which can be sprayed or dropped into the nose to shrink the polyps. If successful, this type of treatment can significantly reduce the size of the polyps and alleviate congestion as a result.
In cases where the nasal drops or sprays don’t work, or if your nasal polyps are advanced and large, your doctor may recommend steroid tablets instead.
Surgical Treatment for Nasal Polyps
Nasal polyps that don’t respond to medications may require surgery to fix. The surgical techniques most commonly used to address nasal polyps are polypectomy and endoscopic sinus surgery.
During a polypectomy, a surgical instrument called a microdebrider is used to carefully cut away the nasal polyps. This is a minor surgery and is usually performed as an outpatient procedure.
Endoscopic Sinus Surgery
If your polyps are large, the doctor may recommend endoscopic sinus surgery in place of a polypectomy. This is the most common treatment option for nasal polyps and involves the insertion of an endoscope (a thin, flexible instrument with a tiny camera and tools on the end) into the nose. This can then be used to cut and remove polyps and any other obstructions in the nasal cavities; like the polypectomy, this is usually an outpatient surgery.
Potential Complications of Surgery to Remove Nasal Polyps
In many cases, surgery significantly improves the symptoms of people with nasal polyps. Unfortunately, recurrence is common, and nasal polyps have been found to grow back 18 months after endoscopic sinus surgery in around 40% of cases. Other possible side effects from the surgery include:
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- NCBI (Chapter 7: Nasal polyps.)
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- NCBI (Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis)