Nasal polyps and similar nasal conditions make up a broad group of growths and swellings that arise from the inner lining of the nose and sinuses, most of which are benign. These conditions usually show up as slowly worsening nasal congestion, loss of smell and postnasal drip. An accurate diagnosis matters both for controlling symptoms and for making sure rare but serious conditions are not missed.<\/p>\n
Nasal polyps form when the lining (mucosa) of the nose and sinuses becomes waterlogged after long-standing inflammation and droops down into grape- or teardrop-shaped growths. They are soft, pale gray-pink and usually do not cause pain. Most arise from the ethmoid sinus area on the side wall of the nose and fill the nasal cavity as they grow. They are not related to cancer.<\/p>\n
The term polyposis describes multiple polyps on both sides of the nose. Today this condition is also called “chronic rhinosinusitis with nasal polyps.” Chronic rhinosinusitis means inflammation of the nasal and sinus lining lasting longer than 12 weeks; the polyps are a visible result of that inflammation.<\/p>\n
Polyps usually appear after age 30, most often in middle age, and are slightly more common in men. They are seen more frequently in people with asthma, aspirin sensitivity or an allergic tendency. In children, polyps on both sides call for investigation of an underlying condition such as cystic fibrosis.<\/p>\n
Not every growth inside the nose is a polyp. The main conditions that can look similar on examination are:<\/p>\n
Because nasal polyps and similar conditions cause very similar complaints, they cannot be told apart by symptoms alone. A definitive diagnosis is therefore made through endoscopic examination and, when needed, imaging and pathology. This distinction also determines the treatment method and how often follow-up is needed.<\/p>\n
Exactly why polyps develop is not fully understood, but they are thought to result from ongoing inflammation in the lining rather than from a single cause. In most patients this inflammation is rich in eosinophils, immune cells that also play a role in allergy and asthma.<\/p>\n
Conditions known to increase the risk of polyps include:<\/p>\n
The combination of asthma, nasal polyps and aspirin sensitivity is called “Samter’s triad,” or aspirin-exacerbated respiratory disease. In these patients, polyps tend to be more extensive and more likely to recur after surgery. In inverted papilloma, certain types of human papillomavirus (HPV) are thought to play a role.<\/p>\n
Small polyps may cause no symptoms at all and may be found by chance during an examination for another reason. As polyps grow larger and more numerous, the complaints become more noticeable:<\/p>\n
Loss of smell is one of the most typical symptoms of nasal polyposis and is often noticed even before the congestion. In patients with asthma, asthma control may worsen as the polyps grow.<\/p>\n
Signs such as one-sided blockage, bloody nasal discharge, numbness in the face or upper teeth, displacement of the eye or double vision do not fit a simple polyp picture. These symptoms suggest inverted papilloma, a mucocele or, more rarely, a tumor, and require prompt evaluation.<\/p>\n
The first step is a detailed history and an ENT (ear, nose and throat) examination. Large polyps can be seen even by looking into the nostril, but evaluating the deeper parts of the nose requires nasal endoscopy. With a thin camera, this examination shows the location and size of the polyps, whether they are on one or both sides and how they relate to the sinus openings.<\/p>\n
Other methods used during diagnosis include:<\/p>\n
Patients traveling from abroad are encouraged to bring previous CT or MRI scans (ideally the images themselves, not only the reports), pathology results and a list of their medications, including any courses of oral steroids.<\/p>\n
The goals of treatment are to shrink the polyps, improve nasal breathing and the sense of smell, reduce sinusitis episodes and delay recurrence. The plan is tailored to the type and extent of the disease.<\/p>\n
Corticosteroid nasal sprays are the foundation of treatment in chronic rhinosinusitis with nasal polyps. Used regularly over the long term, they help shrink polyps and reduce symptoms. Saline nasal rinsing clears mucus and helps the medication reach the lining more effectively.<\/p>\n
In patients with marked congestion, a short course of oral steroids can shrink polyps quickly; because of side effects, however, more than a few courses a year are generally avoided. Antihistamines may be added for accompanying allergy and leukotriene modifiers for aspirin sensitivity. Antibiotics are used only during bacterial infection episodes.<\/p>\n
For patients with severe nasal polyps that keep returning despite surgery and standard treatment, biologic medications that target specific steps of the inflammatory process may be used. Given as injections under the skin at regular intervals, they can reduce polyp size and improve the sense of smell in suitable patients. The decision to start biologic therapy is made according to specific criteria and under specialist supervision.<\/p>\n
Endoscopic sinus surgery is performed for patients who do not get enough relief from medication. Without any external incision, the polyps are removed and the blocked sinus openings are widened using a camera and fine instruments passed through the nostrils. Surgery also helps medications reach the sinuses more effectively.<\/p>\n
In an antrochoanal polyp, removing the polyp’s root inside the sinus, and in inverted papilloma, fully clearing the area where the tumor arises, are important for preventing recurrence. In mucocele and allergic fungal sinusitis, endoscopically opening the sinus and draining its contents is the main treatment.<\/p>\n
Because polyposis is a chronic inflammatory disease, treatment is not considered finished after surgery. Continuing steroid sprays and nasal rinsing regularly and having endoscopic check-ups at set intervals allow any recurrence to be spotted early.<\/p>\n
Alongside medication and surgery, some habits also help keep the disease under control:<\/p>\n
These measures can help slow polyp regrowth and reduce the need for oral steroid courses.<\/p>\n
Although nasal polyps are benign, left untreated they can significantly reduce quality of life. Long-term congestion can lead to sleep problems, frequent sinusitis and worsening asthma. Very rarely, in advanced disease, serious situations such as a sinus infection spreading to the area around the eye can occur.<\/p>\n
Polyps can grow back over time despite appropriate treatment, especially in patients with asthma and aspirin sensitivity. This does not mean treatment has failed; it reflects the nature of the disease and can be kept under control with regular follow-up. Long-term use of oral steroids has side effects such as bone loss, high blood sugar and stomach problems, so they should never be used without medical supervision.<\/p>\n
See an ENT specialist without delay in the following situations:<\/p>\n
Polyps usually do not disappear by themselves. They can shrink and symptoms can ease with medication, but they may grow again when treatment is stopped. That is why long-term follow-up is needed.<\/p>\n
Inflammatory polyps on both sides are benign and do not turn into cancer. However, some one-sided growths may be inverted papilloma or, more rarely, other tumors. For this reason, pathology testing is recommended for any one-sided or suspicious-looking growth.<\/p>\n
Surgery removes the polyps and ventilates the sinuses, but it does not eliminate the underlying tendency toward inflammation. As a result, polyps may form again over the years in some patients. Regular spray use and check-ups help reduce this risk.<\/p>\n
Smell loss is mostly caused by polyps blocking airflow to the smell area and by inflammation in that region. When polyps shrink with treatment or are removed surgically, the sense of smell improves partly or fully in many patients. If the disease recurs, however, smell may decrease again.<\/p>\n
Polyps on both sides are rare in children and may be a sign of a condition such as cystic fibrosis. A one-sided polyp in a child is most often an antrochoanal polyp. In either case, the child needs a thorough evaluation.<\/p>\n
Op. Dr. Tayfun Demirel, ENT specialist, evaluates patients with nasal polyps and similar nasal conditions at the practice in Ata\u015fehir, Istanbul, using endoscopic examination and the necessary imaging. Depending on the type and extent of the disease, medication, surgical options and a long-term follow-up plan are created individually. Please contact the clinic to book an appointment. This article is for informational purposes only; an in-person examination is required for diagnosis and treatment.<\/p>\n","protected":false},"excerpt":{"rendered":"
Nasal polyps and similar nasal conditions make up a broad group of growths and swellings that arise from the inner lining of the nose and sinuses, most of which are benign. These conditions usually show up as slowly worsening nasal congestion, loss of smell and postnasal drip. An accurate diagnosis matters both for controlling symptoms […]<\/p>\n","protected":false},"author":1,"featured_media":1257,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[],"class_list":["post-1341","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-treatments"],"_links":{"self":[{"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/posts\/1341","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/comments?post=1341"}],"version-history":[{"count":1,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/posts\/1341\/revisions"}],"predecessor-version":[{"id":2167,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/posts\/1341\/revisions\/2167"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/media\/1257"}],"wp:attachment":[{"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/media?parent=1341"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/categories?post=1341"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/tags?post=1341"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}