Nasal Polyps
What Are Nasal Polyps?
Nasal polyps are noncancerous, soft, and painless growths that develop in the mucosal lining of the nasal passages or paranasal sinuses. They are typically the result of chronic inflammation and can significantly affect nasal function and overall sinus health.
Although they can occur at any age, nasal polyps are more common in adults and in individuals with asthma, allergies, or recurrent sinus infections. Polyps may develop in one or both nostrils, often bilaterally and symmetrically, and may vary in size from tiny lesions to large masses that block normal airflow and drainage.
What Causes Nasal Polyps?
The exact cause of nasal polyps is not always clear. However, several factors are known to contribute to their development:
- Chronic inflammation of the nasal mucosa
- Allergic rhinitis (hay fever)
- Asthma
- Recurrent or untreated sinus infections
- Fungal sinusitis
- Aspirin-exacerbated respiratory disease (AERD)
- Genetic and anatomical predispositions
- In some cases, the cause cannot be clearly identified
In many patients, the polyp itself aggravates the underlying inflammation, forming a vicious cycle that may lead to chronic rhinosinusitis with nasal polyps (CRSwNP).
Symptoms of Nasal Polyps
The presence of nasal polyps can lead to a variety of bothersome symptoms, including:
- Chronic nasal congestion or blockage
- Loss or reduction of the sense of smell (anosmia)
- Loss or reduction in the sense of taste
- Mouth breathing or nasal-sounding voice
- Snoring or sleep disturbances
- Postnasal drip and throat clearing
- Facial pressure or fullness
- Recurring sinus infections
As polyps grow or multiply, patients may experience worsening symptoms that mimic or overlap with chronic sinusitis, severely affecting quality of life.
Diagnosis of Nasal Polyps
Accurate diagnosis is essential for proper treatment planning. Evaluation includes:
- Endoscopic nasal examination
- A small camera (nasal endoscope) is used to visualize polyps and assess their size and location inside the nasal passages and sinuses.
- Imaging studies
- Sinus CT (computed tomography) scans help evaluate the extent of disease and rule out structural problems or deeper sinus involvement.
- Histological examination (biopsy)
- In some cases, especially if the polyp appears atypical or grows rapidly, a biopsy may be needed to exclude other conditions such as inverted papilloma or malignancies.
Treatment Options for Nasal Polyps
Treatment depends on the underlying cause, the severity, and recurrence risk. The two main approaches are medical and surgical:
- Medical Treatment
Medical therapy aims to reduce inflammation and shrink or eliminate the polyps:
- Intranasal corticosteroids (e.g., fluticasone, mometasone): First-line treatment to reduce inflammation and polyp size
- Oral corticosteroids: Used in short bursts for larger or more symptomatic polyps
- Antibiotics: Prescribed if secondary bacterial sinus infection is suspected
- Antihistamines: For patients with allergic triggers
- Leukotriene inhibitors: Especially useful in aspirin-sensitive individuals
- Biologic therapies (e.g., Dupilumab): A newer class of medication targeting inflammatory pathways in severe or refractory cases
- Surgical Treatment
If medical therapy fails or polyps are extensive:
- Endoscopic Sinus Surgery (ESS) is the most common surgical intervention
- Performed under general anesthesia
- Involves removal of polyp tissue and opening blocked sinus pathways to restore ventilation and drainage
- Minimally invasive with high success rates
Surgery can provide long-term relief but is often combined with continued medical therapy to prevent recurrence.
Why Personalized Evaluation Is Important
Each patient’s nasal polyp condition may stem from different underlying mechanisms. In some cases, medications alone are ineffective, and surgery is necessary. In others, surgery provides only temporary relief, and long-term immunotherapy or biologic treatment is required to control inflammation and prevent regrowth.
That’s why a comprehensive ENT evaluation, including nasal endoscopy, imaging, and sometimes microscopic tissue analysis, is essential to create a customized treatment plan.
Nasal polyps are more than just nasal “tissue overgrowths.” They represent a chronic, often relapsing inflammatory disease of the upper airways. With timely diagnosis and appropriate therapy—whether medical, surgical, or both—most patients can achieve significant symptom relief and improved quality of life.
If you are experiencing persistent nasal congestion, loss of smell, frequent sinus infections, or breathing through your mouth, consult an ENT specialist for a full assessment.
Frequently Asked Questions (FAQ)
ARE NASAL POLYPS RELATED TO CHRONIC RHINOSINUSITIS?
Yes, nasal polyps are often closely related to chronic rhinosinusitis. Nasal polyps are soft, non-cancerous growths that develop on the lining of the nasal passages or sinuses due to long-term inflammation. They can block normal sinus drainage, worsen congestion, and contribute to persistent sinus infections.
Many patients with chronic rhinosinusitis have nasal polyps, and their presence can make symptoms more severe. Treating nasal polyps through medications or surgery can be an important part of managing chronic rhinosinusitis effectively.
HOW MANY TYPES OF NASAL POLYPS ARE THERE?
Nasal polyps are generally classified based on their size, location, and underlying cause. While there is no strict number of “kinds,” they can be broadly categorized into many types:
- Allergic (Inflammatory) Nasal Polyps
These are the most common type of nasal polyps and result from chronic inflammation in the nasal mucosa. They are often associated with allergies, asthma, and chronic sinus infections. Allergic polyps typically appear as soft, painless, grape-like growths inside both nasal passages. - Antrochoanal Polyps
Originating from the maxillary sinus (located behind the cheeks), these polyps extend into one side of the nasal cavity. They are more common in children and young adults and usually affect only one nostril. Unlike allergic polyps, antrochoanal polyps tend to be solitary. - Cystic Fibrosis-Related Polyps
Patients with cystic fibrosis often develop nasal polyps at a younger age due to thick mucus secretions and chronic sinus inflammation. These polyps can be more aggressive and recurrent. - Polyps Associated with Aspirin-Exacerbated Respiratory Disease (AERD)
Also known as Samter’s Triad, this condition includes asthma, aspirin sensitivity, and nasal polyps. Polyps in these patients tend to be large, recurrent, and resistant to medical treatment. - Other Rare Types
In rare cases, nasal polyps may be caused by fungal infections or tumors (benign or malignant), which require different treatment approaches and careful diagnosis.
DO NASAL POLYPS AND CHRONIC SINUSITIS RECUR AFTER SURGERY? IS THE SURGERY PERMANENT?
Whether nasal polyps recur after surgery depends entirely on the underlying histopathology and the technique used during the operation. Before surgery, it is usually explained if the polyps are likely to recur and, if so, within what timeframe.
In some types of polyp disease, complete healing occurs after surgery, and the polyps do not return.
