Nasal Polyps

Conditions of the Nose and Paranasal Sinuses » Nasal Polyps

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

Nasal Polyp

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.

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