Nasal polyps

• Causes, incidence, and risk factors

  Nasal polyps typically start near the ethmoid sinuses (located at the top of the inside of the nose) and grow into the open areas. Large polyps can block the sinuses or nasal airway.

  People with the following conditions are more likely to also have nasal polyps:

  • Aspirin sensitivity (wheezing)
  • Asthma
  • Chronic sinus infections
  • Cystic fibrosis
  • Hay fever (allergic rhinitis)
• Symptoms

  People with nasal polyps often complain about having a cold that has lasted for months or years.

  Symptoms include:

  • Mouth breathing
  • Nose feeling blocked (nasal obstruction)
  • Reduced or complete loss of sense of smell (not common with sinus infection)
  • Runny nose

  Headaches or pain are NOT common unless there is also a sinus infection.

• Signs and tests

  Examining the nose shows a grayish grape-like mass in the nasal cavity.

  A CT scan of the sinuses will show opaque (cloudy) spots where the polyps are.

• Treatment

  Medications help relieve symptoms but rarely get rid of nasal polyps.

  • Nasal steroid sprays may help with nasal blockage or runny nose, but symptoms return if treatment is stopped. There are many brands available. They are safe for adults and children.
  • Corticosteroid pills or liquid may also improve symptoms.
  • Antibiotics should only be taken if there is a bacterial sinus infection.

  Some people may need surgery, such as functional endoscopic sinus surgery (FESS).

• Expectations (prognosis)

  Removing the polyps with surgery usually makes it easier to breathe through the nose. Over time, however, nasal polyps often return. Reduced or lost sense of smell does not always improve following treatment with medicines or surgery.

• Complications
  • Bleeding
  • Infection

  Nasal polyps may come back.

• Calling your health care provider

  Call for an appointment with your health care provider if you regularly have difficulty breathing through your nose.

• Prevention

  Although there is no real way to prevent nasal polyps, therapy aimed at the cause can help. Nasal sprays, antihistamines, and allergy shots may help prevent polyps that block the airway.

  Also, aggressive medical treatment of sinus infections is helpful.

• References
  Bachert C, Gevaert P, van Cauwenberge P. Nasal polyps and rhinosinusitis. In: Adkinson NF Jr., Bochner BS, Busse WW, Holgate ST, Lemaske RF Jr., eds. Middleton's Allergy: Principles and Practice. 7th ed. Philadelphia, Pa; Mosby Elsevier; 2008: chap 56.

Review Date: 10/9/2009

Reviewed By: Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.