Nasal polyps are soft, jelly-like overgrowths of the lining of the sinuses. They look like grapes on the end of a stalk. They occur in around 1 in 200 people, mostly by the age of 40 years.
Symptoms of nasal polyps
Polyps do not always cause symptoms but as they grow down from the sinuses into the nasal cavity, the result is usually a stuffy nose and reduced sense of smell along with sinus infections.
Causes of nasal polyps
There are many theories but no one cause of nasal polyps. It could start with an infection. It’s rarely genetic. Environmental allergies seldom cause polpyps but they can make symptoms worse.
Nasal polyps occur in:
- 15% of asthma patients
- 25% of cystic fibrosis patients
- Most asthma patients with aspirin sensitivity
Treatment
- For limited polyps, steroid nasal sprays alone may be effective
- If the condition is more widespread then sinus surgery is the usual path.
- Postoperative rinsing, especially with steroids can reduce recurrence rate in many patients but if not there are mulitple medication options. Biologic drugs that target the precise mechanism of polyp growth and development include Dupixent, Tezspire, Nucala and others. The medications are well tolerated and extremely effective to the point that most patients never require a second surgery
- People with aspirin allergy, nasal polyps and asthma have the option of aspirin desensitization, which can reduce asthma severity, the rate of polyp regrowth and the severity of sinusitis. With the advent of biologics this is now done less frequently
