Nasal polyps (i.e., nasal polyposis) are soft tissue growths that form on the lining of the nasal passages and inside the sinuses (i.e., air-filled cavities within the facial bones). They are painless and non-cancerous. They are usually in the shape of teardrops and characteristically look like glistening moist grapes. Nasal polyps generally develop when the mucus membranes of the nose and/or sinuses are chronically inflamed. This results the tissue to swell up over a prolonged period of time.
When the nasal polyps grow large enough, they can obstruct the nasal passages and cause breathing difficulties due to the polys blocking the flow of air through the nose. They can also block the free passage of secretions from the sinuses into the nose and predispose individuals to sinus infections.
Any condition which results in chronic inflammation inside the nose and sinuses can lead to nasal polyp formation. Some of these conditions include:
- Allergic rhinitis (i.e., hay fever)
- Chronic sinusitis
- Aspirin sensitivity
- Cystic fibrosis
- Eosinophilic disorders
- Allergic fungal sinusitis
What are the causes of nasal polyposis?
It is believed that inflammation causes the buildup of fluid within the mucus membranes. When this buildup of fluid occurs, it results in the formation of fluid-filled growths, which over time expand to become polyps.
There is a condition known as Samter’s triad which is characterized by nasal polyps, asthma, and aspirin intolerance. Samter’s triad is also known as aspirin exacerbated respiratory disease (i.e., AERD) or aspirin triad.
What are the symptoms of nasal polyps?
- Nasal congestion
- Runny nose
- Post-nasal drip
- Decreased or lack of the sense of taste and/or smell
- Sinus and/or facial pressure
- Sinus headaches
How is the diagnosis of nasal polyps established?
- Endoscopic examination of the nose
- Imaging studies (e.g., X-rays, CT scans)
- Allergy testing (e.g., skin testing or blood testing)
- Sweat test to rule out cystic fibrosis (particularly in children)
What are some complications that may arise as a result of having nasal polyps?
- Long-term or repeated sinus infections
- Nose bleeds (i.e., epistaxis)
- Exacerbations of asthma
- Obstructive sleep apnea
- Double vision (i.e., diplopia)
How are nasal polyps treated?
Corticosteroid nasal sprays are the usual first line of treatment. Decongestants are sometimes useful to help shrink the size of the nasal polyps. Antibiotics may be needed in the event that a bacterial sinus infections occurs due to the nasal polyps.
If the nasal polyps continue to grow in spite of treatment with various medications and/or if complications arise, the polyps may need to be surgically removed. It must be noted, that it is not uncommon for nasal polyps to “grow back” after they are surgically removed, especially if an underlying untreated allergy causing chronic inflammation is still present. The recurrence of the nasal polyps can be as quick as a few months after surgical intervention, however, it also may take a couple of years for the nasal polyps to return. Some studies have demonstrated that regular use of a corticosteroid nasal sprays can reduce the chances of polyp regrowth after surgery.
How can nasal polyps be prevented?
The aggressive treatment of predisposing conditions such as hay fever (i.e., allergic rhinitis) with a combination of environmental controls [a reduction of the exposure to offending aeroallergens (e.g., dust mites, molds, pollens, cats, dogs, cockroaches)], medications, and desensitization procedures (i.e., allergy shots, allergy injections, allergy immunotherapy, allergy hyposensitization) may inhibit polyp formation. Avoidance of exposure to smoke, strong odors, and chemicals is important in order to reduce nasal irritation and excessive tissue growth.
Patients with established chronic sinusitis may require antibiotics, nasal/sinus irrigations, and/or sinus surgery. Patients with a history of aspirin sensitivity will do better after desensitization to aspirin in terms of better asthma control, as well as a reduction in recurrences of nasal polyps.
The board certified allergists at Black & Kletz Allergy located in the Washington, DC, Northern Virginia, and Maryland metropolitan area will readily answer any questions you have regarding nasal polyps and/or allergy symptoms. We have 3 offices with locations in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All of our offices offer on-site parking. In addition, the Washington, DC and McLean, VA offices are accessible by Metro. There is also a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. Please make an appointment by calling any one of our 3 offices, or alternatively, you can click Request an Appointment and we will respond to your request within 24 hours by the next business day. Black & Kletz Allergy diagnoses and treats both adults and children and we are proud to serve the Washington, DC metro area residents for which we have done for more than 50 years.