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Nasal Polyps

By

Marvin P. Fried

, MD, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine

Last full review/revision Jun 2020| Content last modified Jun 2020
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Nasal polyps are fleshy outgrowths of the mucous membrane of the nose.

  • Nasal polyps are more likely to develop in people who have allergies or asthma.

  • Some of the symptoms caused by polyps are nasal obstruction and congestion.

  • Doctors usually diagnose nasal polyps based on their characteristic appearance.

  • Corticosteroids can shrink or eliminate polyps, but sometimes polyps must be removed surgically.

Polyps are common teardrop-shaped growths that form around the openings to the sinus cavities. A mature polyp resembles a peeled, seedless grape. Unlike polyps in the colon or bladder, polyps in the nose are not tumors and do not suggest an increased risk of cancer. They are merely a reflection of inflammation, although there may be a family history of the problem.

Polyps may develop during nasal or sinus infections and may disappear after the infection subsides, or they may begin slowly and persist. Nasal polyps also can form if a foreign body is in the nose. Some people who are allergic to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) have a combination of asthma, chronic nasal and sinus congestion, and nasal polyps. It is not clear how the nasal polyps are related to the allergy and the other respiratory tract symptoms. People with nasal polyps can develop sinus infections if the polyps block drainage from the sinuses. Rarely, people develop rhinosporidiosis (an infection in the nose characterized by bleeding polyps), which can cause chronic rhinitis.

Symptoms

Many people are not aware that they have nasal polyps, although they may have

  • Sneezing

  • Nasal congestion

  • Obstruction

  • Drainage of fluid down the throat (postnasal drip)

  • Facial pain

  • Excessive discharge from the nose

  • Loss of smell (anosmia)

  • Reduced ability to smell (hyposmia)

  • Itching around the eyes

  • Chronic sinus infections

Diagnosis

  • A doctor’s evaluation

  • Sometimes biopsy

Doctors usually diagnose nasal polyps based on their characteristic appearance.

The doctor may perform a biopsy of the polyp to ensure that it is not a cancer.

Treatment

  • Corticosteroids

  • Sometimes surgery

Corticosteroids in the form of nasal sprays or oral tablets may shrink or eliminate polyps. Surgical removal of polyps is needed if they block the airways or cause frequent sinus infections.

Polyps tend to grow back unless the underlying irritation, allergy, or infection is controlled. Using an aerosol corticosteroid spray may slow recurrences. Doctors may need to periodically use nasal endoscopy (looking in the nose with a small rigid or flexible viewing tube) to evaluate and treat people with persistent or recurring problems. People who have severe symptoms caused by recurring polyps may need to have portions of their sinuses removed or corrected. Most surgical procedures are done with an endoscope (a flexible viewing tube).

If polyps cause repeated episodes of sinusitis, these episodes can be decreased by dupilumab, a monoclonal antibody (an antibody that is produced in a laboratory from living cells). Dupilumab can help by shrinking the polyps.

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