Nasal polyps

The specific cause of nasal polyps remains unclear, but several factors are associated with their development:

• Chronic Inflammation: Conditions that cause long-term inflammation in the sinuses or nasal passages, such as chronic sinusitis, can lead to polyp formation.
• Asthma and Allergic Conditions: Individuals with asthma, allergic rhinitis (hay fever), or sensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) are at an increased risk.
• Genetic Predisposition: There may be a genetic component, as nasal polyps tend to occur within families.
• Immune System Responses: Abnormal responses of the immune system to fungi or bacteria may contribute to chronic inflammation and polyp growth.

Symptoms and Impact on Quality of Life

Nasal polyps can lead to a range of symptoms, depending on their size and location:

• Nasal Congestion and Obstruction: A sensation of constant stuffiness or blockage in the nose, which can lead to difficulty breathing through the nose.
• Postnasal Drip: Excess mucus production may cause mucus to drip from the back of the nose into the throat.
  Reduced Sense of Smell and Taste: Large polyps can block the flow of air through the nasal passages, impairing these senses.
• Facial Pain or Pressure: Inflammation in the sinuses can cause discomfort around the face, particularly around the eyes, forehead, or cheeks.
• Recurrent Infections: Blocked sinus passages can lead to infections, manifesting as recurrent sinusitis.

These symptoms can significantly compromise an individual’s quality of life, disrupting sleep, daily activities, and overall well-being.

Diagnosis of Nasal Polyps

Diagnosis typically involves a combination of a clinical examination and diagnostic tests:

• Nasal Endoscopy: A flexible tube with a camera (endoscope) is inserted into the nasal passages, providing a detailed view of the interior and allowing for direct observation of polyps.
• Imaging Studies: CT scans can offer comprehensive images of the sinuses and nasal passages, helping to determine the size and extent of polyp growth and evaluate the surrounding structures.
• Allergy Testing: Identifying underlying allergic conditions can be crucial in managing inflammation and preventing polyp recurrence.
• Cystic Fibrosis Testing: In children with nasal polyps, testing for cystic fibrosis is often recommended, as polyps can be an early sign of this condition.
  

Treatment Options

Treatment for nasal polyps aims to reduce their size or eliminate them altogether, alleviating symptoms and improving nasal function:

• Corticosteroids: Nasal sprays, drops, or oral corticosteroids can help shrink polyps and reduce inflammation. Long-term use, however, must be carefully managed due to potential side effects.
• Surgery: In cases where polyps significantly obstruct the nasal passages or do not respond to medication, surgery may be necessary. Endoscopic sinus surgery is commonly used to remove polyps and clear sinus passages, improving drainage and airflow.
• Biologic Therapies: For patients with severe, persistent polyps, particularly those associated with conditions like severe asthma, biologic medications targeting specific immune pathways can be effective.
• Management of Underlying Conditions: Treating associated conditions such as asthma, allergies, or chronic sinusitis can prevent the recurrence of polyps and reduce the need for surgery.

Preventive Measures and Long-Term Management

Preventing the recurrence of nasal polyps involves managing chronic inflammation and treating underlying conditions. Regular follow-ups with an otolaryngologist, consistent use of prescribed treatments, and lifestyle modifications, such as avoiding nasal irritants and practising good nasal hygiene, are essential to long-term management.

Conclusion

Nasal polyps are a common condition associated with chronic inflammation of the nasal and sinus passages. While they are noncancerous and often asymptomatic, larger polyps can lead to significant discomfort and complications. A comprehensive approach to treatment, incorporating medications, potential surgical interventions, and the management of underlying conditions, can provide relief and improve quality of life.

If you experience symptoms suggestive of nasal polyps, booking a consultation with Dr Ker Liang, our Consultant Otolaryngologist from Aglow ENT Centre, is a crucial step toward accurate diagnosis and effective management.