Nasal polyps

Nasal polyps are small swellings or bags of fluid and mucous that occur in the linings of the nose or sinus cavity. They are usually harmless, and may cause discomfort – the most common symptoms they cause are a stuffy, runny nose.

Nasal polyps can vary in size and number. They may occur as a single polyp or sometimes several grow like a small bunch of grapes on a stem. Polyps usually affect both nostrils and can gradually enlarge, blocking the nose.

What causes nasal polyps?

The exact cause of nasal polyps is unknown, but it is often associated with conditions that cause inflammation of the nose such as allergic rhinitis (hayfever), and rhinosinusitis (inflammation of the nose and sinus). It is also more common in people with asthma, cystic fibrosis and allergy to aspirin. 

What are the symptoms of nasal polyps?

At first, the symptoms of nasal polyps are similar to those of having a cold – a blocked or runny nose, but colds usually only last 2 to 14 days and the symptoms improve on their own. If you have nasal polyps, the symptoms will not get better without treatment.

Other symptoms of nasal polyps are:

  • Blocked nose and difficulty breathing through your nose. You may find you have to breathe through your mouth more often. This is especially troublesome at night and your sleep may be affected.
  • Ongoing runny nose.
  • Postnasal drip – this is the feeling of something continually running down the back of your throat. It is due to mucus coming from the back of the nose because of large polyps
  • Changes in your sense of smell and taste. 
  • Fullness or pressure in your face.
  • Headaches and snoring – larger polyps may cause headaches and snoring.
  • Sinus infection – sometimes polyps block the drainage channel of the sinuses into the nose. This can make you more prone to infection of the sinuses (sinusitis).

How are nasal polyps treated?

Medication

The main treatment option for nasal polyps is the use of corticosteroids (steroid) medication. These reduce inflammation in the nose, and over time, shrinks the polyps.

  • For smaller polyps, steroids are given as a nasal spray, for example: Alanase®, Beconase®, Becloclear®, Butacort®, Flixonase®. Read more about steroid nasal sprays.
  • These may take 1 to 2 weeks to make any obvious difference to your symptoms. You will probably be advised to use them for at least 4 to 6 weeks. 
  • For larger polyps, steroids may be given orally, by mouth, as tablets such as prednisone. These are usually taken as a short course, for about 1 to 2 weeks.  

Surgery

An operation may be advised if polyps are large, or if steroid nose drops or tablets have not worked.

  • Polypectomy involves removing the polyps with a surgical instrument. It can be done through the nostrils, either with local anaesthetic (awake) or under general anaesthetic. The type of anaesthetic might depend on the number and size of the polyps, where they are and how fit you are for an operation.
  • Endoscopic sinus surgery is done with a general anaesthetic. It might be done where the polyps are very large and numerous, or where they are seriously blocking your sinuses. The endoscope allows the surgeon to see into the sinuses with a camera and to do the operation in a place that is difficult to reach with normal surgical instruments. 
  • More research is needed to show if medical or surgical treatment gives better outcomes than the other. (2)

Learn more

The following links provide further information on nasal polyps. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.
Nasal polyps The Australasian Society of Clinical Immunology and Allergy (NZ)
Nasal polyps Patient Info, UK (UK)
Nasal polyps NHS Choices (UK)

References

  1. Fokkens WJ, Lund VJ, Mullol J, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl. 2012 Mar;(23):3 
  2. Rimmer J, Fokkens W, Chong LY, Hopkins C. Surgical versus medical interventions for chronic rhinosinusitis with nasal polyps. Cochrane Database of Systematic Reviews 2014, Issue 12.
Credits: Health Navigator Editorial Team. Last reviewed: 05 May 2017