Nasal Polyps Overview and Management

Study Notes

Nasal polyps are painless, benign growths in the nasal passages and sinuses.
They typically develop in adults (30s-40s).
Common causes include asthma, allergic rhinitis, chronic rhinosinusitis, cystic fibrosis, and repeated sinus infections.
Polyps form from inflamed mucous membranes, leading to swelling, redness, and fluid buildup.
Researchers link allergic reactions and infections as causes for the inflammation leading to polyps.

Small polyps may not produce symptoms.
Larger polyps can cause headaches, loss of smell/taste, congestion, nasal drainage, nosebleeds, postnasal drip, facial/sinus pressure, and snoring.

Healthcare providers can use a nasal endoscope (flexible scope with a camera, and light) to view inside the nose.
CT scans may be ordered to obtain detailed images of the sinuses.

Steroid nasal sprays can help shrink polyps.
Oral or injected steroid treatment is also available.
Outpatient surgery may be needed to place stents to prop open the nasal passages and deliver medication, or to remove polyps.

Nasal turbinates are the structures within the nose that warm and moisten the air.
Turbinate hypertrophy occurs when the turbinates become enlarged, blocking airflow.
Causes include chronic sinus inflammation, environmental irritants, seasonal allergies, and bone/soft tissue swelling.
Symptoms include difficulty breathing, dry mouth upon waking (mouth breathing due to nasal obstruction), altered sense of smell, forehead pressure, mild facial pain, prolonged nasal congestion, runny nose, snoring.

Medications to reduce seasonal allergies (e.g., cetirizine, loratadine).
Oral decongestants (e.g., pseudoephedrine, phenylephrine).
Temporary nasal decongestants are sometimes used to relieve congestion, but long-term use can lead to bleeding and ineffectiveness.

Nasal obstruction can lead to snoring, impaired sleep, and sleep-disordered breathing, often from nasal stuffiness or collapsed nostrils.
Risks include fatigue, decreased productivity, increased risk of accidents, depressive symptoms or mood changes, and negative impacts on quality of life.