What are nasal polyps?

28-01-2020 | ENT & DENTAL CENTRE

Inflammation of the lining(mucosa) of the nose and sinuses can cause swelling of the lining. When there is a lot of swelling, polyps are formed. These are bags of soft flesh and look like small white grape like structures.

What factors contribute to polyp formation?
Long-standing infection, allergy or a disorder of the nerve supply of the nose can cause polyps. Patients allergic to house dust and aspirin are more prone to developing polyps. Asthma patients are also at a higher risk.

What problems does the patient have?
The patient may have no problem at all, or may have a feeling of congestion or block in the nose. Watery nasal discharge or a feeling of something going from the back of the nose into the throat are common symptoms.

Loss of taste and smell, headaches, pressure sensation in the face and sinusitis may occur. Sometimes the polyps may be seen coming out of the nose.

What investigations are required?
After a complete examination of the patient, nasal endoscopy, allergy tests and a CT scan may be required.

How are polyps treated?
Treatment may be medical or surgical, depending on the number of sinuses involved by polyps. In patients with small polyps, it is worth trying medical therapy. This consists of intra-nasal steroids with oral antihistamines. Sometimes, oral steroids may also be indicated.

Large polyps are best removed by FESS or Functional Endoscopic Sinus Surgery.

How is the operation done?
FESS is done by using small telescopes called endoscopes attached to a camera. The surgeon operates by watching the view on a television screen. All instruments are passed through the nostrils and no cuts are made on the patient’s face. A special instrument is the latest in the treatment of nasal polyps. This is known as the Microdebrider and it has a tip which sucks in the polyps and then cuts them in a fast but controlled manner. In this way, the operation is quick and relatively bloodless.

Why is FESS the best surgical treatment?
More complete removal of the polyps is possible only by FESS & Microdebrider. This leads to a low rate of recurrence.

Can the polyps occur again?
In a few cases, the polyps may begin to form again. If the patient comes regularly to the surgeon after the operation, then this polyp formation can be detected early and treated with topical steroids in the form of nose drops or a spray.  Oral steroids may also be needed.  This usually takes care of the polyps.  Hence, periodic follow-up is essential after the operation.