Nasal Polyps

Nasal polyps are the most common benign growths in the nasal cavity.  There are many unanswered questions about the incidence, cause, and optimal treatment of these lesions.

Incidence; Causes and Development

Nasal Polyps are more common in adults than in children.

Polyps are seen with greater frequency in people with asthma, allergic rhinitis (hay fever), vasomotor rhinitis (may be caused by emotional upset or sexual arousal), and certain kinds of drug use, chronic sinus infections, and cystic fibrosis.  They can be a sensitivity reaction to aspirin.  About one out of four people with cystic fibrosis has nasal polyps.  Frequently, no specific cause can be found.

Signs and Symptoms

Usually in both sides of the nose, polyps are essentially outgrowths of the nasal mucosa.

The polyps are smooth, gelatinous, semi-translucent, pear-shaped, and pink to white in color.  The polyps originate near the ethmoid sinuses (located at the top of the nose on both sides of the nasal cavity) and grow into the open areas of the nasal cavity.  They sometimes grow large and numerous enough to cause nasal obstruction.

Diagnosis and Tests

Nasal Polyps can occasionally be seen on exam with a nasal speculum.  Sometimes they can only be seen with special equipment.  Since polyps are devoid of sensation, they can be distinguished from other swollen tissues by a lack of pain on probing.

The clinical features of nasal polyps include nasal congestion (100%), loss of smell and/or taste (75%), sneezing and runny nose (60%), post-nasal drip (65%), facial pain (35%), and itchy eyes (25%).

Treatment and Prevention

Conventional medical treatment with a nasal steroid spray and/or a short course of oral corticosteroids is usually effective, shrinking or eliminating the polyps.  Surgery to remove the polyps and infected material is recommended if the medical treatment is not successful.

The problem with these approaches is that they are not addressing the cause.  The best form of treatment would be to find out what the patient is allergic to and try to eliminate it.  This does not only mean what can be inhaled, it can also be an allergy to food substances as well.  Complete allergy testing for inhaled substances and foods should be carried out.  Electric acupuncture has also shown some positive results in the treatment of nasal polyps.

Complications

Nasal polyps are often a contributing factor to complicated bacterial sinus infections.