Nasal Polyps

Conditions of the Nose and Paranasal Sinuses » Nasal Polyps

Definition ≡ Edematous masses in nose (usually from ethmoid sinuses)

Incidence

• More common than you think
• Adults
• If present in child <10 y/o:  rule out cystic fibrosis

Etiology

Unknown, but associated with:

• Allergy
• Chronic sinusitis
• Cystic fibrosis
• ASA sensitivity triad – Asthma, nasal polyps, and aspirin sensitivity (leads to broncho-constriction

Clinical Findings

Symptoms

• Nasal obstruction
• Decreased smell sense
• Anterior watery rhinorrhea

Signs

• Nasal polyps
• Hyponasal voice
• Chronic sinusitis

Diagnosis

• History
• Exam- nasal speculum (+ headlight/mirror), indirect nasopharyngoscopy
• Biopsy (rule out cancer) if unilateral or not “edematous” polyp
• ENT referral, Sinonasal endoscopy
• Imaging – plain sinus x-rays, CT scan

Treatment

• Nasal saline rinses
• Topical nasal steroid spray
• Treat chronic sinusitis if symptoms
• Endoscopic sinus surgery

Complications

• Sinusitis (and it’s complications)
• Permanent loss of smell
• Inverting papilloma

Prognosis

“Polyps are like weeds”.  Difficult to eradicate completely.  Aim of management is, therefore, control of symptoms.