What are Sinus Polyps
Sinus polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They hang down like teardrops or grapes. They result from chronic inflammation due to asthma, recurring infection, allergies, drug sensitivity or certain immune disorders.
Small nasal polyps may not cause symptoms. Larger growths or groups of nasal polyps can block your nasal passages or lead to breathing problems, a lost sense of smell, and frequent infections. Nasal polyps can affect anyone, but they’re more common in adults. Medications can often shrink or eliminate nasal polyps, but surgery is sometimes needed to remove them. Even after successful treatment, nasal polyps often return.
Symptoms of Sinus Polyps
Nasal polyps are associated with inflammation of the lining of your nasal passages and sinuses that lasts more than 12 weeks (chronic rhinosinusitis, also known as chronic sinusitis). However, it’s possible — and even somewhat more likely — to have chronic sinusitis without nasal polyps.
Nasal polyps themselves are soft and lack sensation, so if they’re small you may not be aware you have them. Multiple growths or a large polyp may block your nasal passages and sinuses.
Common signs and symptoms of chronic sinusitis with nasal polyps include:
- A runny nose
- Persistent stuffiness
- Postnasal drip
- Decreased or absent sense of smell
- Loss of sense of taste
- Facial pain or headache
- Pain in your upper teeth
- A sense of pressure over your forehead and face
- Itching around your eyes
What Causes Sinus Polyps?
It’s not clear why some people develop chronic inflammation or why ongoing inflammation triggers polyp formation in some people and not in others. The inflammation occurs in the fluid-producing lining (mucous membrane) of your nose and sinuses. There’s some evidence that people who develop polyps have a different immune system response and different chemical markers in their mucous membranes than do those who don’t develop polyps.
Nasal polyps can form at any age, but they’re most common in young and middle-aged adults. Nasal polyps may form anywhere in your sinuses or nasal passages, but they appear most often in an area where sinuses near your eyes, nose and cheekbones all drain through winding passages into your nose (ostiomeatal complex).
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- Asthma, a disease that causes overall airway inflammation and constriction
- Aspirin sensitivity may cause some people to be more likely to develop nasal polyps
- Allergic fungal sinusitis, an allergy to airborne fungi
- Cystic fibrosis, a genetic disorder that results in the production and secretion of abnormally thick, sticky fluids, including thick mucus from nasal and sinus membranes
- Churg-Strauss syndrome, a rare disease that causes the inflammation of blood vessels
Your family history also may play a role. There’s some evidence that certain genetic variations associated with immune system function make you more likely to develop nasal polyps.
The treatment goal for nasal polyps is to reduce their size or eliminate them. Medications are usually the first approach. Surgery may sometimes be needed, but it may not provide a permanent solution because polyps tend to recur.
Nasal polyp treatment usually starts with drugs, which can make even large polyps shrink or disappear. Drug treatments may include:
- Nasal corticosteroids. Your doctor is likely to prescribe a corticosteroid nasal spray to reduce inflammation. This treatment may shrink the polyps or eliminate them completely. Nasal corticosteroids include fluticasone (Flonase, Veramyst), budesonide (Rhinocort), flunisolide, mometasone (Nasonex), triamcinolone (Nasacort AQ) , beclomethasone (Qnasl, Beconase AQ) and ciclesonide (Omnaris, Zetonna).
- Oral and injectable corticosteroids. If a nasal corticosteroid isn’t effective, your doctor may prescribe an oral corticosteroid, such as prednisone, either alone or in combination with a nasal spray. Because oral corticosteroids can cause serious side effects, you usually take them only for a brief period. Injectable corticosteroids may be used if nasal polyps are severe.
- Other medications. Your doctor may prescribe drugs to treat conditions that contribute to chronic inflammation in your sinuses or nasal passages. These may include antihistamines to treat allergies and antibiotics to treat a chronic or recurring infection. Aspirin desensitization and treatment may benefit some patients with nasal polyps and aspirin sensitivity.
In endoscopic surgery, the surgeon inserts a small tube with a magnifying lens or tiny camera(endoscope) into your nostrils and guides it into your sinus cavities. He or she uses tiny instruments to remove polyps and other obstructions that block the flow of fluids from your sinuses.
Your surgeon may also enlarge the openings leading from your sinuses to your nasal passages. Endoscopic surgery is usually performed as an outpatient procedure.
After surgery, you’ll likely use a corticosteroid nasal spray to help prevent the recurrence of nasal polyps. Your doctor may also recommend the use of a saltwater (saline) rinse to promote healing after surgery.