Nasal Polyposis

What is nasal polyposis?

Nasal polyposis is characterized by benign, painless growths in the nasal passages and sinuses, called nasal polyps. These growths hang down like teardrops. While the polyps themselves are not painful, they can cause issues with breathing if they are too big or grow too closely together. They can appear anywhere in the nasal passages or sinuses, but they are most common in the area where the sinuses drain into the nasal passages.

Nasal polyposis can affect anyone, but it is more common in adults. They are also associated with asthma, recurring infections, allergies, sensitivities to drugs, and certain immune disorders.

What are the symptoms of nasal polyposis?

Nasal polyps lack sensation, so if they are small one may not know they are there at all. It is when they grow to block the nasal passages or sinuses that they cause symptoms. These symptoms include:

Persistent stuffy nose
Runny nose
Postnasal drip
Loss of the sense of smell or taste
Headache
Pain in the face and/or upper teeth
A sense of pressure over the forehead and face
Snoring
Frequent nose bleeds

There are complications that are associated with nasal polyps if they block normal airflow and fluid drainage. Obstructive sleep apnea, asthma flare-ups, and sinus infections are all possible complications.

What causes nasal polyposis?

Polyps are triggered by irritation and inflammation in the nasal passages and sinuses. However, healthcare professionals do not fully understand what causes the long term inflammation or why it triggers the polyps. Evidence exists that points to immune responses and chemical markers in the mucous membranes causing nasal polyposis. There is also evidence that a genetic component plays a role in nasal polyposis. It is believed that there is an inherited immune system response that may lead to this condition.

There are risk factors that may contribute to the development of nasal polyps. Any condition that is characterized by chronic inflammation and irritation in the nasal passages and sinuses may trigger polyps to form. These conditions include infections, allergies, asthma, aspirin sensitivity, allergic fungal sinusitis, cystic fibrosis, Churg-Strauss syndrome, and vitamin D deficiency.

How is nasal polyposis diagnosed?

A diagnosis is usually possible with a physical exam, questions about symptoms, and a closer examination of the nose. Other tests that may be conducted include a nasal endoscopy, imaging studies, allergy tests, tests for cystic fibrosis, and blood tests.

What are the treatments for nasal polyposis?

Treatment begins with managing whatever condition is leading to the long term inflammation. A plan should be made with one’s physician to treat these conditions if they are known. For nasal polyposis specifically, the goal is to shrink or eliminate the polyps. The first step is typically medication. Options for medication include nasal, oral, and injectable corticosteroids, dupilumab, or other medications that deal with nasal swelling. Surgery to remove the polyps is an option, but as the growths tend to recur, it is not the first choice.

There are ways to reduce the chance of nasal polyposis. Managing allergies and asthma may help to reduce inflammation and lower the risk of polyps. Avoiding things that may irritate the nasal passages and sinuses is also helpful. Other preventative measures include humidifying one’s home, practicing good hygiene, and using a nasal rinse.