Nasal Polyps
Nasal polyps are the result of swelling of the sinus lining. Polyps in other areas of the body are not related to nasal polyps. Nasal polyps are associated with asthma, aspirin sensitivity, cystic fibrosis, allergies and allergic fungal sinusitis. Nasal polyps are benign and rarely turn into cancer.
Endoscopic image of nasal polyps.
Nasal polyps causes nasal obstruction and blocks the openings of the sinuses. The mucus produced by the sinuses cannot escape and eventually becomes infected. Patients experience thick discolored nasal drainage, facial pain and considerable thick post-nasal drip. Often times, patients have no sense of smell.
Some patients with mild nasal polyps are asymptomatic and do not require treatment, however, in those patients with severe polyps and symptoms, medical and surgical management is indicated.
Medical management includes systemic and nasal steroids. Systemic steroids, like prednisone, are highly effective in shrinking and controlling polyps, however, the short and long-term side effects do not allow long-term use. Nasal steroid sprays are very safe because they are not absorbed by the body but are consequently less effective in controlling nasal polyps.
When polyps are causing severe symptoms and medicines are not effective in management, functional endoscopic sinus surgery is indicated. Sinus surgery is effective to debulk polyp disease, however, post-operative control is critical to avoid polyp recurrence. Specialized tissue shavers and computer guided surgery are two technologies that make surgery for nasal polyps more thorough and decrease the chance of recurrence.
Eventually, nasal polyps will recur. To reduce the number of surgeries required diligent post-operative care and endoscopic surveillance is recommended.
