A nasal polyp (NP) is a soft, fleshy swelling that grows inside the nose. It may be yellowish, gray or pink in color. Nasal polyps are found in varying degrees. Sometimes it is only one, but they can also be like a ‘small bunch of grapes’ growing on a stem. They are common. A nasal polyp is almost always benign, but nasty.
Cause
In most cases, the cause is not known. It is thought that a sustained (chronic) inflammation in the nose causes the excess growth of the lining of the nostrils. This can sometimes lead to the development of small polyps. These slowly grow bigger then. Polyps usually affect both nostrils. The cause of the inflammation is often unclear. Certain circumstances stimulate nose inflammation and polyps, including asthma, allergy to aspirin, cystic fibrosis and some rare nose conditions.
Symptoms
The size of nasal polyps can vary greatly. Normally they are the size of small water droplets, but in rare cases they can also grow to the size of small grapes. Nasal polyps can have the following signs and symptoms:
- An obstructed feeling in the nose. Breathing through the nose can be difficult, so usually breathing has to be done through the mouth. This is especially inconvenient at night and can disrupt sleep.
- Runny nose (rhinorrhoea) is common.
- A ‘post-nasal drip’ can occur. This is the feeling that there is always something running in the back of the throat, due to the mucus that comes from the large polyps.
- Smell and taste have sometimes weakened or disappeared.
- A stuffy nose can change the voice.
- Large polyps can cause headache and snoring.
- Large polyps can cause swelling of the nose and face.
- Sometimes, polyps block the drainage canals of the sinuses. This allowes a person to be more susceptible to infection of the sinuses (sinusitis).
- Large polyps sometimes hinder breathing at night and can cause sleep apnea.
Diagnosis
To make the diagnosis, a doctor will check, with the aid of a special instrument, whether there are indeed polyps in the nose. If necessary, the patient will be referred to the ear, nose and throat (ENT) specialist, who can better examine the patient by means of nasal endoscopy under local anesthesia. Depending on the symptoms and severity, treatment can be started then.
Treatment
As a treatment for nasal polyps, nasal drops, nasal spray or possibly short-term tablets including corticosteroids are usually prescribed. These shrink the nasal polyps, reducing the symptoms.
If this doesn’t help, an ENT specialist can remove nasal polyps by surgery. During polyp extraction, the visible part of the nasal polyp is removed under local anesthesia. The part that resides in the cavity cannot be removed by this operation. This may be done by endoscopic sinus surgery. The removed tissue can then be examined, to exclude the possibility that it’s a malignant nasal polyp.
Prognosis
After polyp extraction, there is a high probability that the nasal polyp returns. Removing the complete lining of the affected sinus as well, in addition to the polyp, can help to prevent recurrence. Usually, long-term corticosteroid-containing nasal spray is given after the surgery, possibly allowing nasal polyps to be back less quickly.
