Nasal Polyps

Nasal polyps are abnormal, soft, swollen, sac-like growths of inflamed tissue. They line the inside of your nose or your sinuses.

The sinuses are a group of air-filled spaces inside the bones of your face. They connect with the nasal cavity. This is the large, air-filled space behind your nose. Normally these spaces are fairly open, but nasal polyps can grow large enough to block them. This can cause trouble breathing.

Nasal polyps are a subgroup of chronic rhinosinusitis. This is a condition where the nasal cavity and sinuses are inflamed for more than 4 to 12 weeks. But not all people with this condition will develop nasal polyps.

Other types of growths sometimes form in the nasal cavity. Some of these types may be cancer. But true nasal polyps are not cancer.

Nasal polyps are fairly common. Anyone can have them.

Researchers are still learning about the causes of nasal polyps. Underlying inflammation of your tissue plays some sort of role. Nasal polyps are more common in people with these health conditions:

• Asthma
• Aspirin sensitivity
• Chronic sinus infections
• Cystic fibrosis
• Hay fever (allergic rhinitis)

Certain genes may also help lead to the development of nasal polyps. This is especially true of genes that play a role in the immune system and inflammatory response. You may be more likely to have nasal polyps if other members of your family have had them.

If you have nasal polyps, you may feel like you have a cold for months or longer. Some of your symptoms may be due to the nasal polyps. Others may result from the chronic rhinosinusitis that caused your polyps.

The most common symptoms of nasal polyps include:

• Stuffy nose (nasal congestion)
• Runny nose
• Facial sinus fullness (but usually not pain)
• Postnasal drip
• Reduced sense of smell
• Feeling blocked in your nose and having to breathe through your mouth

Unless you also have an infection, you shouldn’t have symptoms, such as fever or yellowish or greenish drainage from the nose. Complications from nasal polyps may cause additional symptoms.

The symptoms of nasal polyps may seem like other health conditions or problems. Always see your healthcare provider for more information.

Treatment will depend on your symptoms, age and general health. It will also depend on how severe the condition is.

Treatment aims to reduce inflammation, as well as the size of your polyps. Healthcare providers often start treatment with steroid medicines breathed in (inhaled) through the nose. These medicines can decrease the inflammation at the root of the problem. People who don’t respond to this might need steroid medicines taken by mouth.

Other treatments for nasal polyps include:

• Medicines to help decrease inflammation (antileukotrienes)
• Antibiotics for possible infection
• Nasal steroid sprays
• Daily rinsing of the sinuses with a saltwater solution
• Antihistamines to reduce allergic reactions
• Allergen immunotherapy and removal of allergens, if possible
• Aspirin desensitization therapy, if appropriate
• A biologic medicine called dupilumab given as a shot (injection) every other week

You may still have symptoms despite these other therapies. If this is the case, surgery may help. Surgery does often get rid of most symptoms. But the polyps may come back within a few months to a few years. It is important to address the underlying cause of your nasal polyps to help prevent this from happening. After your surgery, you may need to take inhaled nasal steroids to help keep the polyps from returning.

Nasal polyps sometimes cause problems. Sinus infections are common complications. These infections may come back often and become long-lasting (chronic). If you get a bacterial infection, you may need treatment with antibiotics.

Less commonly, nasal polyps cause problems from more dangerous infections, such as:

• Infection of the tissue around the brain and spinal cord (meningitis)
• Infection around the tissue around the eye (orbital cellulitis)
• Infection of the sinus bones (osteitis)

Your healthcare provider will watch your symptoms carefully to make sure you don’t have these problems. If you have one of these complications, you might need antibiotics. In very rare cases, you might need surgery as well.

Very large nasal polyps can also sometimes block your nasal passageway during sleep. This is called obstructive sleep apnea. This might make you very tired and drowsy the next day. It’s important to let your healthcare provider know if this is one of your symptoms.