What are nasal polyps and how would I know if I had them?

Mr Kalpesh Patel, a leading ENT surgeon, explains what nasal polyps are and how they can be treated. Nasal polyps are swollen linings of the sinuses, specifically, the ethmoid sinuses. This swelling results in the formation of numerous little bags of water that dangle in the nasal cavity, like a bunch of grapes. In most cases, they are not visible to the naked eye, but they can grow to a size where they do become visible and drop out of the nostrils.

Nasal polyps are often confused with the ends of nasal turbinates which are normal anatomical features of the nasal cavity. The nasal turbinates are responsible for warming, dehumidifying and filtering the air as we breathe in. Nasal polyps are extremely rare in children and are generally confined to adult patients.

How do you know if you have nasal polyps?

The first signs of nasal polyps are:

• A history of nasal congestion.
• An altered sense of smell.
• Having colds that last for much longer than would be expected.
• Patients may also have mucous and pus in their nasal cavity.

In people with nasal polyps, a history of allergy is extremely common. Alternatively, nasal polyps can also occur following an infection.

How are nasal polyps diagnosed and treated?

A diagnosis of nasal polyps is best made using an endoscope (camera) in the nose, undertaken by an ENT specialist. Nasal polyps have a characteristic appearance and can easily be identified on camera by a trained specialist. Further diagnosis can be made by CT scanning of the sinuses if necessary.

Medical treatment is the go-to for treating nasal polyps, which involves taking a combination of steroids, antihistamines and antibiotics. To avoid recurrence, maintenance treatment may also be needed which can consist of a low-dose, long-term use of steroids. Patients will usually report seeing an improvement in 7-10 days after starting medical treatment.

If medical treatment fails, which occurs in roughly 30% of cases, endoscopic sinus surgery will be required. This is a routine, day-case and minimally-invasive procedure that removes the polyps and opens up the sinuses to improve drainage. After this procedure, medical treatment is prescribed again which will be much more effective following surgery.

It is important to note that nasal polyps do have a strong tendency to recur, especially when medical treatment is stopped or not followed properly.

If you think you may be suffering from nasal polyps, make an appointment with a specialist.