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Nasal Polyps

By

Marvin P. Fried

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

Medically Reviewed Dec 2021 | Modified Sep 2022
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Nasal polyps are fleshy outgrowths of the nasal mucosa that form at the site of dependent edema in the lamina propria of the mucous membrane, usually around the ostia of the maxillary sinuses.

Symptoms include obstruction and postnasal drainage, congestion, sneezing, rhinorrhea, anosmia, hyposmia, facial pain, and ocular itching.

Diagnosis generally is based on physical examination. A developing polyp is teardrop-shaped; when mature, it resembles a peeled seedless grape.

Treatment of Nasal Polyps

  • Topical corticosteroid spray

  • Sometimes surgical removal

Corticosteroids (eg, mometasone [30 mcg/spray], beclomethasone [42 mcg/spray], flunisolide [25 mcg/spray] aerosols), given as 1 or 2 sprays 2 times a day in each nasal cavity, may shrink or eliminate polyps, as may a 1-week tapered course of oral corticosteroids. In patients with severe chronic rhinosinusitis with nasal polyps, biologics (eg, dupilumab) have been effective by shrinking the polyps and improving symptoms (1 Treatment reference Nasal polyps are fleshy outgrowths of the nasal mucosa that form at the site of dependent edema in the lamina propria of the mucous membrane, usually around the ostia of the maxillary sinuses... read more Treatment reference ).

Surgical removal of nasal polyps is required in many cases. Polyps that obstruct the airway or promote sinusitis are removed, as are unilateral polyps that may be obscuring benign or malignant tumors.

Polyps tend to recur unless the underlying allergy or infection is controlled. After removal of nasal polyps, topical beclomethasone or flunisolide therapy tends to retard recurrence. In severe recurrent cases, maxillary sinusotomy or ethmoidectomy may be indicated. These procedures are usually done endoscopically.

Treatment reference

  • 1. Bachert C, Han JK, Desrosiers M, et al: Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials [published correction appears in Lancet. 394(10209):1618, 2019]. Lancet 394(10209):1638–1650, 2019. doi:10.1016/S0140-6736(19)31881-1

Drugs Mentioned In This Article

Drug Name Select Trade
Anacin Adult Low Strength, Aspergum, Aspir-Low, Aspirtab , Aspir-Trin , Bayer Advanced Aspirin, Bayer Aspirin, Bayer Aspirin Extra Strength, Bayer Aspirin Plus, Bayer Aspirin Regimen, Bayer Children's Aspirin, Bayer Extra Strength, Bayer Extra Strength Plus, Bayer Genuine Aspirin, Bayer Low Dose Aspirin Regimen, Bayer Womens Aspirin , BeneHealth Aspirin, Bufferin, Bufferin Extra Strength, Bufferin Low Dose, DURLAZA, Easprin , Ecotrin, Ecotrin Low Strength, Genacote, Halfprin, MiniPrin, St. Joseph Adult Low Strength, St. Joseph Aspirin, VAZALORE, Zero Order Release Aspirin, ZORprin
Asmanex, Asmanex HFA, Elocon, Nasonex, Propel, Propel Contour, PROPEL Mini, PROPEL Mini with Straight Delivery System, SINUVA
Beclovent, Beconase AQ, Qnasl, Qnasl Children's, QVAR, QVAR RediHaler, Vancenase, Vancenase AQ, Vanceril
Aerobid, Aerobid -M, Aerospan, Nasalide, Nasarel
DUPIXENT
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