What is a nasal polyp?
A nasal polyps is a type of growth in the cavity of the nose. It may also be found or originate from the sinus cavities. It enlarges over time, growing from a small lump into a large mass that can even block parts of the nasal cavity. Nasal polyps are benign growths that are actually fluid-filled sacs. It develops as a result of a severe and ongoing inflammation of the nasal lining and it is not cancerous. Polyps within the nasal cavity is a result of ongoing inflammation in the nose, which may or may not be due to allergies. This condition of nasal polyp growth is known as nasal polyposis.
Causes of Nasal Polyps
Nasal polyps are growth that develop with inflammation of the lining of the nasal cavity. The reason why these growths appear in some inflammatory conditions in certain people and not in others is not clearly understood.
There is some evidence that suggests that individuals with nasal polyp have a different immune response. Such individuals also show presence of certain chemical markers in their mucous membrane that is thought to trigger the development of nasal polyps.
In addition to these, there are several other respiratory and allergic diseases that can lead to formation of polyps. These consist of allergic rhinitis, asthma, cystic fibrosis and Churg-Strauss syndrome. Individuals who exhibit intolerance towards aspirin may also be at risk of nasal polyps.
Nasal polyps are not the same as a boil or abscess which occurs as a result of an infection. Although it is a growth, and a benign type of tumor of the nose, it is not a solid mass of cells as is the case with a typical tumor.
Nasal Polyp Symptoms
Nasal polyps that are small in size are asymptomatic meaning that there are no symptoms. However, nasal polyps tend to grow over time and symptoms eventually become evident. Often these symptoms are not immediately associated with nasal polyps unless further tests are undertaken. Very large polyps and multiple nasal polyps are more likely to cause symptoms that small to medium-sized polyps or a single nasal polyp.
A nasal polyps can cause a physical obstruction of the nasal passages. This hampers breathing through the nose, either on one side or both sides, depending on the location of the polyp.
This occurs due to a blocked nose. Polyps that are large in size are more likely to contribute to snoring.
Inflammation of the sinus passages occurs due to formation of nasal polyps. These growths obstruct the outflow of mucus from the sinuses and allow for infections to arise within the sinus cavities.
Loss of smell
Anosmia is a loss of sense of smell due to the obstruction caused by nasal polyps. It can be partial (hyposmia) or a total loss (anosmia). Sometimes underlying conditions like hay fever or sinusitis is the cause of a loss of smell and polyps just worsen it.
Loss of Taste
The sense of taste is closely linked to the sense of smell. Since smell is adversely affected with nasal polyps, the sense of taste is equally impaired.
Inflammation of the nasal lining leads to overproduction of mucus. This is seen as a runny nose when it leaks out through the nose or post nasal drip when it drains down the back of the throat. Post nasal drip also causes a constant clearing of the throat action due to irritation of the throat.
Blockage due to the polyp and subsequent mucus accumulation in the nose can cause a nasal tone to the voice.
Accumulation of mucus and infection of the paranasal sinuses leading to sinusitis is the more likely cause of a headache associated with a nasal polyp.
Larger nasal polyps can contribute to facial pain although this is an uncommon symptoms. It should be investigated further as facial pain may be due to other causes unrelated to the polyps itself.
Nasal Polyps Treatment
A nasal polyp is difficult to treat with medication alone. Most of the time the polyp continues to grow in size and medication simply slows it growth. Only small polyps may be treated completely with medication where the growth shrinks and then disappears. However, surgery is often needed to physically remove the polyp.
Nasal Polyp Medication
Corticosteroids are the main option in the medical treatment of nasal polyps. However, other measures to control the inflammation of the nasal lining in conditions like allergic rhinitis may eventually lead to the polyp shrinking on its own.
Nasal sprays that include corticosteroids such as beclometastone, fluticasone, flunisolide, mometasone, triamcinolone and budesonide are used to ease the inflammation and thereby relieve symptoms of nasal inflammation. It can also help to gradually shrink the polyp and eventually eliminate it altogether.
Nasal drops that contain steroids work in much the same way as corticosteroid nasal sprays. These drops help in reducing the swelling of the nose, clear the blocked nasal passage and reduce the size of the polyps. These drops need to be taken for about 6 weeks and if continued, the dosage should be reduced gradually.
Corticosteroid tablets can also be used for treating polyps and inflammation within the nasal cavity. It is usually not prescribed as it has a systemic effect meaning that it affects the entire body. Corticosteroid tablets are reserved for severe cases.
Nasal Polyp Surgery
Surgical removal of the polyps and other procedures for treating concomitant conditions of the nose and paranasal sinuses are considered when there is a poor response to medication. However, there is a strong risk of recurrence of the polyps even with surgery.
In this procedure, the polyps are surgical removed under local anesthetic. A microdebrider cuts the polyps at its base (root) and should be followed by corticosteroids to prevent any subsequent inflammation or regrowth. However, nasal polyps often recur if underlying nasal conditions are not treated simultaneously.
Functional Endoscopic Sinus Surgery
This is a procedure to open up any obstruction of the sinuses and allow for it to drain more effectively. A functional endoscopic sinus surgery (FESS) is performed by an otorhinolargyngologist (ENT specialist) for sinusitis even without a polyp.