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Causes, symptoms, and treatments of nasal polyps

Nasal polyps are fleshy swellings that grow in the lining of the nose and the paranasal sinuses, which are air-filled cavities that connect the nasal cavity to the rest of the body. They aren’t malignant tumours.

Polyps come in a variety of sizes, colors, and shapes, such as teardrops. They eventually resemble grapes on a stem as they mature.

Polyps can appear in one or both nostrils at the same time, and they can grow alone or in groups.

Large polyps or clusters can obstruct the patient’s ability to breathe and cause their sense of smell. They have the potential to obstruct the sinuses and cause issues such as recurring infections.

Nasal polyps afflict 4-40% of the general population, and males appear to be 2-4 times more likely than females to develop them. People that develop them are usually in their twenties or thirties.

They are more prone to forming in people who have asthma, sinus infections, or allergies. Nasal polyps can occur in children with cystic fibrosis.

The causes

nasal polyps

Nasal polyps are caused by a variety of causes that are unknown. Although non-allergic asthma is associated to a large percentage of cases, no respiratory or allergic trigger is detected in some cases.

Colonic and uterine polyps, which are found in the digestive tract and uterus, respectively, have no relation to nasal polyps.

Although the specific mechanism of polyp creation is uncertain, most studies agree that they are caused by swelling (inflammation) in the nose or sinuses and are not a disease.

Inflammation, according to some experts, causes fluid to accumulate in the interstitial space (the space between mucous-forming cells) of the nose and sinuses. Gravity eventually pushes these heavy cells down, becoming polyps. A bacterial or viral infection, an allergy, or an immunological response to a fungus are all possible triggers, according to scientists.

Nasal polyps most commonly arise around the sinus openings (in the nasal passage), however they can form elsewhere in the nasal passages or sinuses.

Diagnosis

After asking about symptoms and seeing the patient’s nose, a doctor should be able to make a diagnosis. With the help of a lit tool, polyps are frequently visible.

The following tests may be ordered by the doctor:

  • Nasal endoscopy – a narrow tube with a small camera (or magnifying lens) is inserted into the patient’s nose.
  • CT scan – this enables the doctor to locate nasal polyps and other abnormalities linked to chronic inflammation. The doctor will also be able to identify any other obstructions.
  • Skin prick allergy test – if the doctor thinks that allergies may be contributing to polyp development, he or she may do an allergy test.
  • Cystic fibrosis – if the patient is a young child, the doctor may order a cystic fibrosis test.

Treatment options

Nasal polyps are commonly treated with the following methods:

1) Steroids

The doctor may prescribe a steroid nasal spray or drops to reduce inflammation and shrink the polyps. Patients with one or more small polyps are more likely to receive this treatment. The following are examples of possible side effects:

2) Tablets containing steroids

In cases of larger polyps or more severe inflammation, steroid tablets may be administered, either alone or in combination with a nasal spray. Although steroid tablets are successful at shrinking polyps, they carry the risk of more serious side effects, such as weight gain, and should only be used for a few weeks at a time.

3) Additional drugs

Other medications may be used to treat disorders that exacerbate the inflammation. Antihistamines for allergies, antibiotics for bacterial infections, and antifungal medicines for fungus allergies are just a few examples.

4) Surgery

Surgery is only utilised if the polyps are exceedingly large or if the patient’s other therapies have failed.

Polypectomy

The most common method for removing polyps is surgery. A local or general anaesthetic is administered to the patient. In the patient’s nose and sinuses, a long, thin tube containing a video camera is introduced.

Micro-telescopes and surgical equipment are then used to cut away the polyps. To free up the nasal canal, the surgeon may remove small pieces of bone from the nose.

To help prevent recurrence, the patient will most likely be prescribed a corticosteroid nasal spray after surgery. To aid post-surgical healing, some doctors prescribe using a saline (saltwater) rinse.

Natural treatments

If the symptoms of a nasal polyp appear to be related to an allergic reaction, avoiding the allergen that causes the reaction would most likely assist.

Although tea tree oil and other therapies have been suggested, there appears to be little evidence to back them up.

A steam bath might help relieve congestion symptoms.

Only a high therapeutic dose of vitamin D can help lessen symptoms. It is unknown how this works, how it should be supplied, or how effective it might be.

Complications

A big polyp, or cluster of polyps, can sometimes obstruct the flow of air and the drainage of fluids from the sinuses or nasal cavity, resulting in the following complications:

  • Chronic or frequent sinus infections.
  • Obstructive sleep apnea.
  • The structure of the face may be altered, leading to double vision. Sometimes, the eyes may be set wider apart than normal (more common in patients with cystic fibrosis).

Preventive tips

  • Humidity. Consider using a humidifier if your home’s air is dry.
  • Hygiene. Handwashing frequently and thoroughly lowers the risk of bacterial or viral infection, resulting in fewer incidences of sinus and nasal tract inflammation.
  • Irritants. Some people may be able to lower their risk of developing polyps by avoiding irritants such as allergies, chemicals, and airborne pollution (which cause inflammation).
  • Asthma and allergy management. Patients who follow their doctor’s asthma and/or allergy treatment guidelines are less likely to develop nasal polyps.
  • Nasal lavage or nasal rinse. Using a nasal lavage or saline spray to rinse the nasal passages can assist increase mucus flow and remove irritants and allergens.

Sources:

  • http://onlinelibrary.wiley.com/doi/10.1002/lary.23610/full
  • http://www.ncbi.nlm.nih.gov/pubmed/12383287
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179194/
  • https://www.medicalnewstoday.com/articles/177020
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2504067/
  • http://www.hoajonline.com/histology/2055-091X/1/2
  • http://www.mayoclinic.org/diseases-conditions/nasal-polyps/basics/symptoms/con-20023206
  • http://www.nhs.uk/Conditions/Polyps-nose/Pages/Treatment.aspx
  • https://journalotohns.biomedcentral.com/articles/10.1186/1916-0216-42-27

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