Medical Information - ENT - Nasal Polyps

ENT's series: Nasal Polyps

Nasal polyps are growths found in the nose as a result of inflammation of mucous membranes of the nose and sinuses. They cause nasal obstruction, hyposmia (decrease sense of smell) and discharge. Other non-specific symptoms include facial ache, pressure around the eye, frontal headache and postnasal drip.

The cause of nasal polyps is multifactorial. Some studies have suggested that nasal polyps are related to allergy. This may include inhalant allergy such as house dust mite and food allergy. Allergy causes swelling of the lining of the nasal cavity and sinuses. Chronic infection of the sinuses also results in mucosal swelling and polyp formation.

Nasal polyps generally present in both nasal cavities as grape-like swellings (figure 1). If the polyp is unilateral (one-sided), it should be biopsied to exclude inverted papilloma which is a benign growth with malignant potential.

The approach to the management of nasal polyps always starts with medical therapy. A course of steroids, antibiotics, nasal steroid spray and topical decongestants is prescribed to ascertain if the polyps will clinically shrink. This is followed by a CT scan of the sinuses to determine the extent of disease (figure 2). Unless the polyps are very small, endoscopic sinus surgery is usually advocated to relieve the symptoms and arrest progression of the disease.

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