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NASAL POLYPS

nasal obstruction

Nasal Polyps

Nasal polyps are small growths that form on the inside of nasal passages. They are benign growths, meaning they are not cancerous, but can cause a number of problems, nonetheless. Nasal polyps are often associated with sinusitis and are an important cause of nasal obstruction. this article reviews the most important information about nasal polyps including nasal polyp surgery.

Nasal polyp symptoms

Nasal polyps are inflammatory outgrowths;¹ they are small, pearly gray growths of abnormal tissue that appear in the nasal passages near the opening of the sinuses. Nasal polyps symptoms include nearly constant nasal congestion, nasal obstruction, and decreased or absent sense of smell. Nasal polyp symptoms are very similar to chronic sinusitis symptoms. Indeed, many patients with chronic sinusitis also have nasal polyps, a condition called “chronic rhinosinusitis with nasal polyps.”² Interestingly, the classic chronic sinusitis symptoms of headache and facial pain occur less often in patients with nasal polyps.

 

Nasal polyp diagnosis

While your ENT may suspect nasal polys based on your symptoms, but the only way to definitively diagnose nasal polyps is to see them. Your ENT will perform one or more procedures to diagnose nasal polyps. The usual first approach is to use a nasal speculum to open the nostrils and then use a light to illuminate the nasal passages. The presence of nasal polyps confirms the diagnosis.

In most cases, however, your ENT will want to get a more complete picture of your nasal polyps. To do that, you ENT may need to perform a nasal endoscopy. After your anterior (front) nasal passages have been numbed with an anesthetic spray, your ENT places a nasal endoscope (tube with a light) into your nose. Your ENT can see your all your nasal passages, sinus openings, and top of your throat through the endoscope. Any nasal polyps can be visualized, characterized, and documented. This is important for nasal polyp diagnosis, but also for tracking the effects of treatment (do the nasal polyps get better, worse, or stay the same?).

Infrequently, your ENT may order an CT of the sinuses to diagnose nasal polyps, but this is more likely to do done to diagnose chronic sinusitis and/nasal obstruction.

 

What is a mucocele?

People researching nasal polyps may come across the term mucocele. Mucoceles are similar to, but not the same as, nasal polyps. Like nasal polyps, mucoceles are benign growths in the nasal passages around the sinuses. A mucocele, however, is filled with mucus and is not made up of inflammatory tissue per se. Your ENT can distinguish between nasal polyps and mucoceles using nasal endoscopy.

Nasal polyp treatment

Intranasal glucocorticoids (steroids) are the primary nasal polyp treatment.³ Steroid nasal sprays include fluticasone, budesonide, and mometasone. As powerful anti-inflammatory drugs, steroids help decrease the inflammation that causes nasal polyps. Likewise, intranasal steroids are also useful for nasal polyp prevention. By blocking chronic inflammation, intranasal steroids can reduce the chance that nasal polyps will recur.
While intranasal steroids are usually the first-line nasal polyp treatment, they may not be enough to reduce severe nasal polyp symptoms. In those cases, ENTs use oral steroids such as prednisone to reduce inflammation.
Some patients may find relief from nasal polyp symptoms by using intranasal saline irrigation. Likewise, your doctor may prescribe a nasal spray that block leukotrienes such as montelukast or zafirlukast.

Nasal polyp surgery

Patients may not find relief from nasal polyp symptoms through medical treatment alone. If that occurs, your ENT may consider nasal polyp removal. There are several types of nasal polyp surgery³, but most are now performed endoscopically. As with diagnosis, a nasal endoscope can be used to directly visualize the nasal passages and for nasal polyp removal.
It is important to understand that nasal polyps may return after surgery. Patients should receive continue to receive medical treatment even after nasal polyp removal.

ENTs are experts in nasal polyp removal

An ear, nose and throat specialist or ENT is one of the few specialists that performs nasal polyp removal and provides medical polyp treatment. The ENTs at Miami Ear Nose and Throat Doctors have years of experience in treating nasal polyps, chronic sinusitis, nasal obstruction. If you live in or around the Miami metropolitan area and suffer from nasal polyps, contact Miami ENT Doctors to book an appointment.

References

  1. Georgy MS, Peters AT. Chapter 7: Nasal Polyps. Allergy Asthma Proc. 2012;33 Suppl 1:22-23. doi:10.2500/aap.2012.33.3537
  2. Stevens WW, Schleimer RP, Kern RC. Chronic Rhinosinusitis with Nasal Polyps. J Allergy Clin Immunol Pract. 2016;4(4):565-572. doi:10.1016/j.jaip.2016.04.012
  3. Newton JR, Ah-See KW. A Review of Nasal Polyposis. Ther Clin Risk Manag. 2008;4(2):507-512. doi:10.2147/tcrm.s2379

 

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