Nasal Polyp

Nasal polyp is a soft, painless, and noncancerous growth that form on the lining of the nasal passages or sinuses. Polyps hang down like a teardrop or a grape bunch. They result from a chronic inflammation caused by asthma, recurring infections, allergies, sensitivity to drugs, and certain immune disorders.

Small polyps may have no symptoms. But bigger masses, or a group of polyps together can block your nasal passages, or result in respiratory problems, loss of sense of smell, or frequent infections.

Anyone can get affected by nasal polyps, but they are more common in middle-aged people. Medication can be used to shrink or eliminate the polyps. However, surgery is sometimes the solution. Nasal polyps may come back even after effective and successful treatments.

Nasal Polyp

Symptoms

Nasal polyps are associated with inflammation of the lining of the nasal passages or sinuses that last more than 12 weeks (chronic sinusitis). However, it is possible to have chronic sinusitis and not nasal polyps (the chronic sinusitis without polyps is more common).

Polyps are soft growths that lack any sensation. So if they are small, you may not be aware of them. Only multiple polyps, or a large one may block your nasal passage.

Common signs and symptoms of chronic sinusitis with nasal polyps are:

· Runny nose

· Blocked nose

· Postnasal drip

· Impaired or absent sense of smell

· Facial pain or headache

· Pain in the upper teeth

· Feeling pressure over the forehead and face

· Snoring

· Itching around the eyes

How to diagnose a nasal polyp?

Polyps can be detected when your doctor looks into the nasal passages through the nasal cavity with the aid of a medical lighted instrument called a rhinoscope. If the polyp is hidden deep in your sinuses, your doctor may examine your nose using endoscopy. In this method, your doctor inserts a narrow flexible tube with a camera and light on one end through the nasal passages.

A MRI or CT scan may also be needed to diagnose the exact size and location of the polyp. Polyps appear as opaque spots in these scans. Image studies can also find other types of growths, which medically might be more serious such as structural abnormalities or cancerous tumors.

An allergy test can also be helpful in diagnose the source of the nasal chronic inflammation. In this method, your doctor makes a small puncture, the size of a needlepoint, on your skin, and then places all kinds of allergens, in the form of liquid, over that puncture, and observes the reaction of the immune system of your body to these allergens.

A small child with a nasal polyp may need to have genetic testing.

When to see a doctor?

If the symptoms of a nasal polyp persist for more than 10 days, you should see a doctor. The symptoms of a chronic sinusitis and nasal polyps are similar to many other diseases such as a simple cold.

If you are experiencing the following conditions, you should visit a doctor immediately:

· Serious breathing problem

· If your symptoms get worse rapidly

· Double vision, loss of vision or inability to move the eyes

· Severe inflammation of the eyes’ surrounding

· Increased headache along with high fever or inability to keep the head forward

What causes nasal polyps?

Scientists have not yet fully understood what causes nasal polyps. It is not clear why some people tend to develop chronic inflammations, or why in some people recurring inflammations cause polyps and in some people not. These swellings occur in the mucous membrane inside the nose and sinuses. Evidence suggests that people whose body tends to produce polyps have different chemical indicators and immune system response to those whose body does not develop polyps.

Nasal polyps can occur at any age, but it is more common in middle-aged people. Polyps can form anywhere inside the sinuses and nasal passages; however, it mostly grows in the area where the sinuses are close to the eyes, nose, and cheekbone.

Treatment

Chronic sinusitis, with or without polyps, is a challenging condition to treat.

The treatment goal for nasal polyps is to either reduce their size or eliminate them completely. Medication is usually the first approach. Sometimes, surgery may be needed, but it may not lead to a permanent outcome, as polyps usually tend to recur.

Medication

Treating nasal polyps usually begins with medication, which can even shrink large polyps and destroy them.

Common medications are:

Nasal sprays (corticosteroids): Your physician probably prescribes these nasal sprays in order to reduce the inflammation of the nose. This treatment might shrink nasal polyps or eliminate them entirely. Corticosteroid sprays include: fluticasone, budesonide, flunisolide, mometasone, triamcinolone, beclomethasone, and ciclesonide.

Oral and injectable corticosteroids: If corticosteroid sprays do not work, your doctor may prescribe an oral corticosteroid such as prednisone, either alone or along with a spray. Since oral corticosteroids can cause serious side effects, you take them for a limited period. Injectable corticosteroids may be used if the nasal polyp is severe.

Other medications: Your doctor may prescribe medicines to treat conditions that contribute to chronic inflammation in your sinuses or nasal passages. These include antihistamines that can treat allergies, and antibiotics that can treat chronic or recurring infections. Aspirin desensitization and treatment can also benefit some patients with nasal polyps.

Nasal polyp surgery

If medication does not shrink or eliminate nasal polyps, you may need endoscopic surgery to eliminate them, and to treat problems that cause inflammation in sinuses and polyp development.

Nasal polyp surgery

In endoscopic surgery, the surgeon inserts a small tube with a magnifying lens and a small camera (endoscope) into your nostrils and guides it towards your sinus cavities. He or she uses a tiny instrument to scrape the polyps and other obstructions that have blocked the flow of fluids from your sinuses.

He or she may also enlarge the opening of your sinuses leading to the nasal passages. Endoscopic surgery is usually performed as an outpatient procedure.

You will most likely use corticosteroid sprays after surgery. This helps prevent the recurrence of nasal polyps. Your doctor may also suggest the use of a saltwater rinse to promote the healing process after surgery.

Who is more prone to nasal polyps?

Middle-aged individuals: Nasal polyps are more common in middle-aged individuals over 40 years old, and in children with asthma, chronic sinusitis, flu, and cystic fibrosis (an inherited disease leading to respiratory problems).

Women: Women are more prone to nasal polyps than men.

How to prevent nasal polyps?

You can prevent another nasal polyp by following the instructions below:

Using nasal rinse

· Managing allergies and asthma: Follow your doctor’s instructions to manage your asthma and allergy. If your symptoms did not improve, inform your doctor so he or she can provide you with a new treatment plan.

· Avoiding nasal stimuli: Avoid air pollutants, which cause inflammation and burning of the nose and sinuses, as much as possible. These pollutants include: allergens, tobacco smoke, chemical gases, dust, and other fine particles in the air.

· Maintaining hygiene: Use a humidifier if the air inside your house is dry. This helps moisturize the respiratory passages, improve the flow of mucous in the sinuses, and prevent blockage and inflammation of the nose.

· Using nasal rinse: Use a saltwater spray to rinse your nasal passages. This improves the flow of mucous, and cleanses the nose from allergens and other stimuli.

Cleansing the nose with a saltwater rinse