What are Nasal polyps?
Generally defined, nasal polyps are the smooth, semi-transparent, nontender, benign polypoidal masses that occur in the lining of the nasal mucosa or anywhere in the paranasal sinuses. These growths arise usually following diseases in the nasal cavity.
A nasal polyp can be sorted into antrochoanal and ethmoidal types. Less frequent are the anthrochoanal polyps that occur singly and unilaterally in the maxillary sinuses. The latter occur bilaterally in several numbers in the ethmoidal sinuses.
Signs and Symptoms
- One or numerous, clustered, grape-like polyps
- Yellow brown to pink in color
- Soft with a jelly-like consistency
- Difficulty breathing
- Stuffy, runny nose
- Perennial nasal congestion
- Constant dripping
- Diminished or absence sense of smell
- Poor sense of taste
- Dull headache
- Massive polyps cause airway obstruction and may alter facial figure
- Mouth breathing
- Eye itching
Nasal Polyp Pictures
The involved processes that result to the formation of polyps remain unclear. Anyone can have it, but usually, children (antrochoanal type) and individuals aged 40 years old and up (ethmoidal type) are the most commonly affected. Patients with asthma, recurrent rhinosinusitis, chromium exposure, aspirin intolerance and cystic fibrosis are more susceptible.
Data support the assumption that people with nasal polyposis have different immune system responses and distinctive chemical markers than others. The presence of a chronic inflammation in the nasal cavity may cause fluid to accumulate in that area as blood vessels become more permeable. Eventually, by virtue of gravity, the fluid-filled cells are dragged down resulting to exvagination of the typical nasal mucosa, thus, the formation of these polypoidal masses.
Treatment is directed with the intention of reducing the size and completely eliminating nasal polyposis.
- The first approach is pharmacologic intervention which includes the use of oral and topical nasal corticosteroids (prednisone). This however, is avoided to be injected directly into the blood vessels as doing so may result to unilateral vision loss.
- Other drugs which offer benefit are antihistamines and antibiotics.
- Activity restriction is not required.
- Nasal saline irrigation with sinus rinses (warm salt water) depresses the formation of polyps
- Steroidal sprays (Momentasone furoate)
If maximum medical therapy falls short in reducing the size of multiple benign nasal polyps, surgical intervention such as polypectomy and functional endoscopic sinus surgery comes in. These options are more likely to be the only alternative for those with cystic fibrosis in which steroid is unpromising.
- For isolated polyps in small number, a simple polypectomy is done. In this procedure, a miniature mechanical suction apparatus called as microdebrider is used to incise and remove the soft tissue.
- A better procedure which not only gets rid of polyps but also facilitates recurrence reduction by opening the clefts where they most frequently occur is functional endoscopic sinus surgery. This is obviously a more massive process with much more considerable impending risks.
- After the operation, the doctor recommends certain activity limitations that include restricting the patient from blowing the nose so as not to increase intranasal pressure and to create additional trauma to already narrowed bony structures.