Nasal Polyps

Nasal obstruction (nasal polyps) is a general term for any blockage within the nose that causes difficulty breathing out of one or both sides of the nose. Nasal obstruction can be caused by a wide variety of conditions including nasal allergies, a deviated septum, enlarged turbinates, and sinus infections.

Nasal polyps­­­ are benign, grape-like growths of inflamed nasal lining that occur in the nasal passages or sinuses.

Small nasal polyps may often cause minimal to no problems and go unnoticed. Large nasal polyps may be very symptomatic. An otolaryngologist such as Dr. Rejowski should be consulted in the treatment of larger nasal polyps, as they can have serious consequences. While nasal polyps can affect anyone, they are more common in adults.

Symptoms

Patients with large nasal polyps may feel as if they have a cold lasting for months or years. Common symptoms often include:

  • Nasal discharge
  • Mouth breathing
  • Loss of the sense of smell
  • Loss of sense of taste
  • Frequent sinus infections
  • Nasal obstruction
  • Snoring
  • Itching around the eyes

Causes

Nasal polyps typically start near the ethmoid sinuses, located between the eyes, and grow into the nasal passages. Larger polyps can block the sinuses or the nasal airway. Nasal polyps tend to develop most often near the openings, or ostia, of the sinuses. People with the following risk factors are more likely to also have nasal polyps:

  • Aspirin sensitivity
  • Asthma
  • Chronic sinus infections
  • Cystic fibrosis (especially in children)
  • Nasal allergies

Treatment

Dr. Rejowski’s goal in treating patients with nasal polyps is to eliminate or reduce the size of polyps and to treat disorders that may contribute to the chronic inflammation of the nasal passages.

Medical Therapy

Typical drug treatments for nasal polyps may include:

  • Nasal steroid sprays, which are often very effective and safe for both children and adults. They reduce inflammation and lessen nasal obstruction and discharge. Nasal steroids stabilize cell membranes and improve ciliary function within the nasal lining. Symptoms may return if treatment is stopped.
  • Oral antibiotics may be helpful in cases when bacterial sinus infection is present.
  • Antifungal agents, such as Sporanox, frequently reduce the size of polyps and reduce signs and symptoms of sinusitis in patients with allergic fungal sinusitis.
  • Oral corticosteroids can be of benefit in reducing the size of inflammatory polyps as well. They are typically not recommended for long term use due to the development of potential side effects.
  • Immunotherapy or allergy management can be useful as well.

Surgical Therapy

When medical treatment fails to control symptoms, Dr. Rejowski may recommend surgery. This is usually done on an outpatient basis.

Endoscopic sinus surgery is a minimally invasive procedure utilizing magnifying telescopes, small forceps and debriding instruments, and computer assisted imaging systems to remove polyps from the sinuses and nasal cavities. Complete removal of the diseased tissues from the sinuses up to the base of the skull can be safely accomplished, with the procedure being done exclusively through the nose. A small sponge pack is placed following the surgery, and is removed the next day. This technique is especially helpful in the management of polyps associated with chronic fungal infections.

 

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