Nasal Polyps

What Are Nasal Polyps?

Nasal polyps are common, noncancerous, teardrop-shaped growths that form in the nose or sinuses. They’re usually found around the area where the sinuses open into the nasal cavity. Mature ones look like peeled grapes.

Often linked to allergies or asthma, they may cause no symptoms, especially if they're small and don’t need treatment. Larger ones can block normal drainage from the sinuses. When too much mucus builds up in the sinuses, they can become infected.

Unlike polyps that form in the colon or bladder, nasal ones are rarely cancer. Experts think that long-term inflammation causes them or that they run in families.

Nasal polyps aren’t painful to the touch. Medications or surgery can treat most. They may come back, though..

Symptoms of Nasal Polyps

If you have any symptoms, they may include:

• Stuffy or blocked nose
• Sneezing
• Postnasal drip
• Runny nose
• Facial pain
• Trouble with sense of smell
• Loss of taste
• Itching around the eyes
• Infections

The most common symptoms are a runny, stuffy, or blocked nose.

Many people also have wheezing, sinus infections, and are sensitive to fumes, odors, dust, and chemicals. It’s less common, but some people with nasal polyps also have a severe allergy to aspirin and reaction to yellow dyes. If you know you have that allergy, ask your doctor to check for nasal polyps.

Nasal polyps make you more likely to have long-term (chronic) sinusitis. Large ones can even change the shape of your nose.

Nasal Polyp Causes and Risk Factors

Nobody really knows what causes nasal polyps, or why they happen in some people, but don't happen in others. Some experts believe it may have something to do with the immune system or the chemical makeup in the lining of your nose and sinuses. But we need more research.

Anyone can get nasal polyps, but they're most common in adults over age 40 and are twice as likely to affect men as women. Children under age 10 rarely get them. If they do, a doctor will check for signs of cystic fibrosis.

Nasal polyps are linked to allergic rhinitis, asthma, aspirin allergy, sinus infections, acute and chronic infections, something stuck in the nose, and cystic fibrosis. But many times, the cause is unknown. Sometimes, people get them before they develop asthma or sinusitis.

Some experts think that symptoms of allergies -- including a runny nose, sneezing, and itching -- make some people more likely to get nasal polyps. But the allergy connection is controversial. Other researchers think that sinus infections are to blame.

Diagnosis of Nasal Polyps

To find out if you have nasal polyps, your doctor will ask you questions about what you're feeling. You'll probably get a physical exam as well.

From there, they'll take a look at your nose using a tool called a nasal endoscope. It has a magnifying lens or camera that provides a detailed view of your nose and sinuses.

If those things don't confirm a diagnosis, your doctor may order more tests, which could include:

• Imaging tests, including computerized tomography (CT)
• Allergy tests, so that your doctor can know if allergies are causing inflammation.
• Blood tests, to check vitamin D levels. If they're low, that can lead to polyps.

Treatment for Nasal Polyps

Medications: If you need treatment, you’ll probably start with a nasal corticosteroid spray. In many cases, that can shrink or even get rid of nasal polyps. But some people need to take corticosteroids such as prednisone by mouth for a week. If that doesn't work, your doctor may give you a shot of a medicine called dupilumab (Dupixent).

Unfortunately, nasal polyps tend to come back if the irritation, allergy, or infection continues. So you may need to keep using a corticosteroid spray and get checkups with a nasal endoscope every now and then.

In general, medications such as antihistamines and decongestants aren’t great at managing nasal polyps. But you may need antihistamines, to control allergies, or antibiotics, if you have an infection, before you start on steroids.

Surgery: Sometimes, nasal polyps are so large that medications don’t work. In such cases, surgery may be an option.

The doctor would likely use a small nasal telescope that removes nasal polyps. You can go home the same day as the surgery.

Surgery helps in most cases. It may be less effective if you have nasal polyps, asthma, and aspirin sensitivity. If that’s you, medication may be more helpful.

Complications of Nasal Polyps

Nasal polyps can block your airflow and keep fluids like mucus from draining properly. They also cause lots of irritation and inflammation while they're forming. All of those things can bring complications, including:

• Sinus infections
• Asthma flare-ups
• Obstructive sleep apnea, a potentially serious condition where you stop and start breathing while you sleep

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