Nasal polyps are painless growths inside the nose or the hollow areas
inside the bones of the face, also known as sinuses. Nasal polyps aren't
cancer.
Small nasal polyps might not cause symptoms. Larger growths or groups of
nasal polyps can block the nose. They can lead to breathing problems,
not being able to smell and infections.
Nasal polyps can affect anyone. But they're more common in young and
middle-aged adults. Medicines can often shrink nasal polyps or get rid
of them. But surgery might be needed to remove them. Even after
treatment, nasal polyps often come back.
Symptoms
Nasal polyps are linked to irritation and swelling, also called
inflammation, of the inside of the nose and sinuses that lasts more than
12 weeks. This is known as chronic sinusitis. But it's possible to have
chronic sinusitis without getting nasal polyps.
People who have small nasal polyps might not know they have them. But
having more than one polyp or having a large polyp can block the nose.
Common symptoms of chronic sinusitis with nasal polyps include:
Runny, stuffy nose.
Mucus running down the throat, also known as postnasal drip.
Not being able to smell.
Not being able to taste.
Facial pain or headache.
Pain in the teeth.
A sense of pressure over the forehead and face.
Snoring.
When to see a doctor
See a health care provider for symptoms that last more than 10 days.
Symptoms of chronic sinusitis and nasal polyps are like those of many
other illnesses, including the common cold.
Seek medical care right away or call 911 or your local
emergency number if you have:
Symptoms that quickly get worse.
Seeing double or other vision changes.
Swollen forehead.
Pain or swelling around the eyes.
A bad headache that keeps getting worse.
Stiff neck.
Causes
Experts don't know what causes nasal polyps. They don't know why some
people get nasal polyps and others don't.
Risk factors
Infections, allergies or any condition that causes long-term
inflammation in the nose or sinuses can increase the risk of having
nasal polyps.
Conditions often linked to nasal polyps include:
Asthma.
Aspirin sensitivity.
Cystic fibrosis.
Dental infections.
Lack of vitamin D.
Having a family history of nasal polyps also might increase the risk.
Complications
One of the most common complications of chronic sinusitis with nasal
polyps is making asthma worse.
Prevention
The following might help lower the chances of getting nasal polyps or
having nasal polyps come back after treatment:
Manage allergies and asthma. Follow your treatment plan. Be
sure symptoms are controlled. See your health care provider if
they're not.
Avoid things that can irritate the nose. These include
tobacco smoke, chemical fumes and dust. If you smoke, talk to your
health care provider about ways to quit.
Wash your hands often and well. This is one of the best
ways to protect against infections that can cause irritation and
swelling of the nose and sinuses.
Use a machine that adds moisture to the air, known as a humidifier. This
might help prevent the nose from getting stuffy and irritated. Clean
the humidifier as directed to keep bacteria from growing.
Use a nasal rinse. Rinsing the inside of the nose with a
saltwater spray or nasal wash might help remove what irritates it.
You can buy saltwater sprays and nasal wash kits without a
prescription. Nasal wash kits come with a neti pot or squeeze bottle
and directions for how to use them.
Use water that's distilled or sterile or has been boiled for one
minute and cooled. The water can also be filtered using a filter
with an absolute pore size of 1 micron or smaller. Rinse the pot or
bottle after each use with the distilled, sterile, previously boiled
or filtered water and leave it open to dry.
Diagnosis
A diagnosis of nasal polyps starts with symptoms, a medical history and
a physical exam.
Tests to diagnose nasal polyps might include:
Nasal endoscopy. This involves using a narrow tube with a
lighted lens or tiny camera to look at the inside of the nose.
Imaging studies. CT scans
can show the size of polyps deep in the sinuses and where they are.
These studies can also help rule out other reasons the nose is
blocked.
Allergy tests. Skin tests can show if allergies are causing
ongoing inflammation. With a skin prick test, tiny drops of
allergy-causing agents are pricked into the skin of the forearm or
upper back. A health care provider then watches the skin for
allergic reactions.
If a skin test can't be done, a blood test can screen for allergies.
Test for cystic fibrosis. A child who has nasal polyps
might have cystic fibrosis. Cystic fibrosis affects the cells that
make mucus, sweat and the juices that help food digest. It's an
inherited condition.
A test for cystic fibrosis is a sweat test. A chemical put on the
skin causes the area to sweat. The test shows if the sweat is
saltier than most people's sweat is.
Blood tests. These can look for a condition linked to nasal
polyps, such as allergies or problems with the immune system.
Treatment
Chronic sinusitis, with or without polyps, is hard to clear up.
Treatment depends on the cause of the swelling and irritation. The goal
is to lessen symptoms and improve life.
Medicines
Treatments might include:
Nasal steroids. These nasal sprays include fluticasone (Flonase
Allergy Relief, Xhance), budesonide (Rhinocort), mometasone (Nasonex
24hr Allergy), triamcinolone (Nasacort Allergy 24HR), beclomethasone
(Beconase AQ, Qnasl) and ciclesonide (Omnaris, Zetonna).
Steroids taken by mouth. Some nasal polyps can block nasal
sprays. If so, taking steroids in pill form such as prednisone might
help. Steroids taken by mouth also might be given to shrink polyps
before surgery.
The pills can be taken alone or with a nasal spray. Because oral
steroids can cause serious side effects, health care providers
generally prescribe them only for a short time.
Steroids given as shots may be used if nasal polyps are severe.
Biologic medicines. Biologics work by aiming at certain
cells or proteins to lessen irritation and swelling. These might be
used for people whose nasal polyps keep coming back. In the United
States, dupilumab (Dupixent), mepolizumab (Nucala) and omalizumab (Xolair)
have been approved for treatment of chronic sinusitis with nasal
polyps.
Other medicines. Other prescription medicines can treat
conditions that lead to long-term swelling and inflammation in the
nose. These might include medicines to treat allergies, also known
as antihistamines, and antibiotics to treat infection.
A treatment known as aspirin desensitization might help people with
nasal polyps and asthma who react badly to aspirin. An allergy
specialist oversees the treatment. The treatment involves taking a
little more aspirin bit by bit to help the body get used to taking
aspirin.
Surgery to remove the polyps might come before aspirin
desensitization. Desensitization might be followed by daily aspirin
therapy.
Surgery
If medicine doesn't shrink or get rid of nasal polyps, endoscopic
surgery can remove polyps and correct problems with the sinuses that
lead to polyps.
In endoscopic surgery, a surgeon puts a small tube with a lighted lens
or tiny camera, also known as an endoscope, through the nostrils into
the sinuses. A surgeon then uses tiny tools to remove polyps.
A surgeon can also make the openings to the sinuses larger. This can be
done during endoscopic surgery. Or there's a procedure called balloon
ostial dilation. This procedure doesn't involve removing tissue from
inside the nose.
After surgery, a corticosteroid nasal spray might help keep nasal polyps
from coming back. A saltwater rinse can promote healing after surgery.
Preparing for your appointment
You'll likely start by seeing your primary care provider. You might then
be referred to an ear, nose and throat (ENT) specialist or an allergy
specialist.
Here's some information to help you get ready for your appointment.
What you can do
Ask a family member or friend to go with you, if possible. Having
someone with you can help you recall the information you get during the
appointment.
Make a list of:
Your symptoms, even if they seem unrelated to your nose or
sinuses, and when they began.
Other medical information, including other conditions you
have.
All medicines, vitamins and supplements you take, including
doses.
Questions to ask your health care provider.
Some basic questions to ask might include:
What is likely causing my symptoms?
What tests do I need?
What treatment do you suggest?
Do I need to see a specialist?
Are there brochures or other printed information I can take have?
What websites do you recommend?
Feel free to ask other questions.
What to expect from your doctor
Your care provider might ask you questions, including:
When did you last have a cold or sinus infection?
How often do you have colds or sinus infections?
Do you have allergies? To what?
Do you have asthma? How controlled is it?
Do you often take aspirin or any other pain medicines?
Do you smoke or are you often around tobacco smoke?
What kind of work do you do?
What are your hobbies?
Have you ever had any sinus or nasal surgery?
Be ready to answer questions so that you
have time to talk about what's most important to you.