Conditions
Nasal polyps are abnormal overgrowths of nasal mucosa, which may be found in the nose cavity, or in the paranasal sinuses. Polyps may be single or multiple.
Causes
Nasal polyps are most often associated with allergic conditions, chronic sinusitis, asthma and aspirin sensitivity. Patients with cystic fibrosis have a higher incidence than normal of nasal polyps.
Symptoms and signs
In most cases, the patient has nasal congestion, and breathes through the mouth. Signs of allergy may be seen, and the patient may have lost his sense of smell (anosmia). Bleeding from polyps may be bothersome. In the nose, polyps look like small grayish clusters of grapes. Some may be quite large, totally blocking the nose.
Treatment
Medical treatment involves topical or systemic steroids, and antibiotics if indicated. Most large polyps, and those not responding to medical treatment, need surgical removal - this is done by endoscopic surgery. Analysis of the removed polyp is mandatory, as a very small percentage may be malignant. Continued steroid spray and sinus rinses after surgery are used to prevent recurrences. Any underlying conditions contributing to the formation of polyps must also receive ongoing treatment. Allergies and sinusitis need aggressive management. Despite these measures, some polyps do recur, and need repeat surgery.
Outcome
The immediate outcome of polyp surgery is excellent, with good relief of symptoms. There is a small recurrence rate after surgery. (Dr AG Hall)