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Nasal polyps

Definition


Disease: Nasal polyps Nasal polyps
Category: Ear, nose, larynx diseases

Disease Definition:

Nasal polyps are tumors on the inside layer of the nasal passages or sinuses that are noncancerous and shaped like teardrops.

 

Nasal polyps that are small might go imperceptible and cause no problems, but the larger ones could obstruct the nasal sinuses or passages and cause frequent sinus infections, breathing difficulties, a loss of the sense of smell and other problems.

 

Children with cystic fibrosis often acquire nasal polyps, but nasal polyps are more common in adults especially those with allergies, frequent sinus infections and asthma; however, nasal polyps can affect anyone.

 

Nasal polyps often return even after successful treatment. Medications can often reduce the size of nasal polyps or remove them, but surgery is occasionally necessary to completely eliminate them.
 

Work Group:


Symptoms, Causes

Symptoms:

Nasal polyps are linked with persistent inflammation of the inside layer of the nasal sinuses (chronic sinusitis) and passages; when having large or several polyps, they might block the nasal sinuses and passages. People with these conditions in the nose and sinuses might experience signs and symptoms like itching around the eyes, snoring, facial pain or headache, postnasal drip, a runny nose, loss of taste, persistent stuffiness, and decreased or no sense of smell; however, people with small nasal polyps may experience no signs or symptoms.

 

Signs and symptoms of nasal polyps are similar to many other conditions including the common cold, and a doctor should be seen if the condition continues for more than 10 days. If severe breathing difficulty is experienced, people ought to call the local emergency number or go to emergency medical care.
 

Causes:

A mucous membrane, tissue that produces sticky fluids (mucus), lines the nasal passages and sinuses. This membrane is covered in tiny hair-like structures called cilia and it contains many tiny blood vessels.

 

When people inhale, the nasal passages and sinuses supply a kind of entrance with lots of nooks and crannies where air can be moistened, cleaned and warmed before going to the lungs. The cilia push away tiny particles in the air that stick to the mucus in the back of the throat or in the front of the nose.

 

If the signs and symptoms of inflammation continue for more than 12 weeks, the nasal or sinus condition will be defined as chronic. Additionally, when the mucous membrane of the nasal sinuses and passages is chronically inflamed, nasal polyps can occur. Nasal polyps usually develop near the openings to the sinuses, but they may appear anywhere throughout the nasal sinuses or passages.

 

The response of the immune system in the mucous membrane appears to lead to the formation of polyps; however, it is not certain how exactly a chronic inflammation causes the development of polyps.
 

Complications

Complications:

The presence of a single large polyp or several polyps (polyposis) might block the flowing out of liquids out of the sinuses or nasal cavity or the normal stream of air. Additionally, complications may occur including frequent or chronic sinus infections; obstructive sleep apnea, a potentially serious condition in which people stop and start breathing many times during sleep; and altered facial structure leading to double vision or uncommonly wide-set-eyes that is more possibly linked with cystic fibrosis.
 

Treatments:

The aims of treatment for nasal polyps are to remove polyps or reduce their size and to treat disorders like allergies that might lead to chronic inflammation in the nasal passages and sinuses. These treatments include medications that might contain nasal or other corticosteroids and surgery.

 

MEDICATIONS:

Nasal corticosteroids:

This treatment might shrink the polyps or remove them completely; the patient may be prescribed a corticosteroid nasal spray to reduce inflammation. These nasal corticosteroids contain budesonide, flunisolide beclomethasone, triamcinolone, and fluticasone.

Other corticosteroids:

The doctor may prescribe an oral corticosteroid, such as prednisone, if a nasal corticosteroid is not effective. These medications are prescribed either in combination with a nasal spray or alone. Oral corticosteroids are usually taken for a brief period because they can cause serious side effects; the doctor may also recommend a corticosteroid injection instead of an oral corticosteroid.

Other medications:

Doctors may prescribe medications to treat conditions that lead to chronic inflammation in the nasal passages or sinuses, such as:

 

  • Antibiotics: To treat a chronic or recurring infection.
  • Antifungal medication: To treat symptoms of fungal allergies.
  • Antihistamines: To treat allergies.

 

SURGICAL TREATMENTS:

Doctors may recommend surgical treatments if drugs don’t remove or reduce nasal polyps. polypectomy and endoscopic sinus surgery are two types of surgeries. The appropriate type of surgery will be chosen depending on the location, number and size of the polyps. 

Polypectomy:

This procedure is performed on an outpatient basis in which small or isolated polyps can be entirely removed using a small mechanical suction device or a microdebrider which is an instrument that cuts and extracts soft tissue.

Endoscopic sinus surgery:

This surgery is also performed on an outpatient basis in which the surgeon inserts an endoscope, is a small tube with a magnifying lens or tiny camera into the nostrils and guides it into the sinus cavities, then, tiny instruments are used to remove polyps and other blocks that prevent the stream of liquids from the sinuses. This surgery removes polyps and corrects problems with the sinuses that make them subject to inflammation and the development of polyps.

 

After surgery, the doctor might recommend the use of a saline (saltwater) wash to speed up the healing process as well as the use of a corticosteroid nasal spray to help prevent the nasal polyps from occurring again.
 

Prognosis:

Not available

Expert's opinion

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