What Are Nasal Polyps?
Nasal polyps are soft, noncancerous growths on the lining of the nose or sinuses. These growths, while painless, can cause blockages that prevent the sinuses from draining properly. This can make it difficult to breathe freely, sleep well, and even think clearly.
At University of Utah Health, our fellowship-trained rhinologists specialize in managing nasal and sinus problems such as nasal polyps. They create personalized treatment plans for people with this common condition and offer advanced treatment, including non-surgical therapies and endoscopic sinus surgery. Some patients participate in U of U Health clinical research trials that are exploring new treatment options for nasal polyps.
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How Nasal Polyps Affect the Sinuses
Sinuses are the network of small, air-filled spaces located in the skull. They link up with the nasal passages and are lined with a specialized layer of cells that make a thin layer of mucus that keeps them moist and healthy. Sinuses are important because they help filter the air we breathe.
Nasal polyps are a severe type of chronic sinusitis, a condition in which the sinuses become inflamed and blocked for 12 weeks or longer despite treatment. Experts believe that this inflammation causes fluid to build up in the mucus membranes. This causes fluid-filled growths, which eventually expand to become polyps. Polyps can become so large that they are visible inside your nose, but this isn’t always the case.
Who Is at Risk for Nasal Polyps?
Some people are more likely to get nasal polyps than others, including people with:
- asthma;
- an allergy to aspirin or other non-steroidal anti-inflammatory pain-relieving drugs;
- a family history of nasal polyps;
- cystic fibrosis;
- allergic rhinitis, an allergic response that causes itchy eyes, sneezing, a stuffy or runny nose, and other symptoms;
- chronic sinus infections;
- allergic fungal sinusitis, an allergic reaction to airborne fungi; and
- other short-term or chronic infections.
Nasal polyps are common in people who have asthma. Nasal polyps affect the upper airway (nose and sinuses), while asthma affects the lower airway (lungs). When a person with asthma has nasal polyps, it’s especially important to control their upper and lower airway symptoms in a coordinated manner. Rhinologists work closely with other specialists, such as pulmonologists, when treating these patients. Together they provide well-coordinated care that leads to the best outcome possible.
Nasal Polyps Symptoms
Common symptoms of chronic sinusitis include:
- difficulty breathing through your nose;
- difficulty sleeping;
- increased mucus in your sinuses and nose (nasal congestion);
- inflammation (swelling) in your nose;
- loss of smell and taste;
- pain over your sinuses, in your ears, upper jaw, and teeth; and
- post-nasal drip (when mucus drains down the back of your throat).
Other symptoms can include:
- fatigue,
- difficulty concentrating,
- headaches, and
- sore throat.
When to Seek Treatment
If your provider thinks you have nasal polyps, the next step is to see a rhinologist. Rhinologists are ear, nose, and throat specialists with additional specialty training to care for patients with nasal polyps.
When to See a Doctor Right Away
In rare situations, chronic sinusitis and nasal polyps can cause symptoms that need immediate medical attention. These occur when a bacterial infection develops in the sinuses and spreads to other areas of the body. If you experience loss of vision, confusion, or dizziness along with nasal and sinus symptoms, call your primary care provider right away.
What to Expect at Your First Appointment
During your first appointment with a rhinologist, the goal is to learn more about your symptoms and medical history and create a personalized treatment plan.
The doctor will talk with you about:
- your symptoms and how long you have been experiencing them,
- what treatments you have already tried, and
- any underlying conditions you have that may be making your symptoms worse.
The only way to diagnose nasal polyps is to see them. If the doctor thinks you may have nasal polyps, several different tests can provide a definite answer.
- A nasal endoscopy involves using a thin tube that’s fitted with a small camera and light to view inside your nose and sinus passages.
- An anterior rhinoscopy involves shining a light into your nose.
- Other imaging tests, such as computed tomography or magnetic resonance imaging, can provide a more detailed picture of where polyps are located.
The doctor might want to do additional tests to provide an accurate diagnosis. This can include:
- blood tests,
- biopsies, and
- allergy testing.
Non-Surgical Treatments for Nasal Polyps
Treatment can reduce the size of nasal polyps and sometimes eliminate them.
If your nasal polyps are small and not causing significant blockages, non-surgical therapies can be effective. This is sometimes referred to as “appropriate medical management” and may include:
- flushing your sinuses with a saline solution,
- using a nasal spray that contains a corticosteroid (anti-inflammatory) medication or adding this medication into your sinus rinse,
- using oral steroid medication, and
- using oral antibiotic medication.
Oral steroids are often the most effective way to reduce the size of nasal polyps. This medication only works while you are taking it, however. If you discontinue using the oral steroid, the symptoms will return.
Your treatment plan may include other strategies if you have an underlying condition that is contributing to inflammation and nasal polyp growth in your nose and sinuses. This can involve taking medicine for allergies or asthma and treating recurring sinus infections with antibiotics.
For many patients with nasal polyps, endoscopic sinus surgery is the most effective treatment option. Your rhinologist may recommend this if appropriate medical management isn’t working well for you.
Nasal Polyps Surgery
The purpose of endoscopic sinus surgery is to remove the nasal polyps that are causing blockages in your nasal passages and sinuses. This will help by:
- allowing your sinuses to drain better and
- providing access for anti-inflammatory medicine to reach your sinuses.
Endoscopic Sinus Surgery: What to Expect
During surgery, the surgeon will access your sinuses using endoscopes inserted into your nose. Imaging technology will allow the surgeon to see the polyps and remove them safely.
The care team will let you know what to expect and how to prepare for your surgery. If you take blood thinners or certain supplements, you will need to stop for two weeks before surgery. The rhinologist may have you take an antibiotic, anti-inflammatory, or steroid medications before or after the surgery takes place.
Endoscopic sinus surgery is minimally invasive and usually done as an outpatient procedure. Patients with other health problems, such as sleep apnea or heart disease, may need to stay at the hospital overnight.
The surgery doesn’t require any external incisions. You won’t have any visible signs of the surgery, such as puffy eyes or swelling. You may experience some pain or discomfort for the first few days after surgery, but over-the-counter pain relievers should provide relief.
After Endoscopic Sinus Surgery
For the first few days after surgery, you will need to rinse your sinuses with a saline solution to keep them clean. The care team will teach you how to do this.
You’ll have a follow-up appointment with your surgeon about a week after the surgery. The doctor will view your sinuses using an endoscope to make sure everything is healing well. After this appointment, you can gradually resume your normal activities.
About a month after your surgery, you will begin using anti-inflammatory nasal sprays or irrigations on a regular schedule. This will help keep your symptoms well-controlled.
What to Expect Long Term
Removing the polyps can provide relief, but more polyps may develop. Your physician will talk to you about ways you can prevent nasal polyps from returning and causing blockages and increased symptoms. These can include:
- using nasal sprays or irrigations that contain anti-inflammatory medicine,
- taking medication to control underlying conditions such as asthma or allergies, which contribute to nasal polyp growth,
- avoiding airborne allergens that can cause inflammation in your nose and sinuses, and
- using a saline spray or rinse to improve mucus flow and remove irritants from your nose and sinuses.
Making an Appointment with a Rhinologist
Referrals are welcome but not necessary when making an appointment with a rhinologist at U of U Health. To make an appointment, call 801-587-8368 or use our online form. Our team will verify your insurance coverage before your visit. If you have had medical tests related to your condition, we will request the results from your provider. Our goal is to make your visit as efficient and helpful as possible.