Chronic sinusitis, with or without polyps, is a challenging condition to clear up completely. You'll work with your health care team to develop the best long-term treatment plan to manage your symptoms and to treat factors, such as allergies, that may contribute to chronic inflammation.
The treatment goal for nasal polyps is to reduce their size or eliminate them. Medications are usually the first approach. Surgery may sometimes be needed, but it may not provide a permanent solution because polyps tend to recur.
Nasal polyp treatment usually starts with drugs, which can make even large polyps shrink or disappear. Drug treatments may include:
- Nasal corticosteroids. Your doctor is likely to prescribe a corticosteroid nasal spray to reduce inflammation. This treatment may shrink the polyps or eliminate them completely. Nasal corticosteroids include fluticasone (Flonase, Veramyst), budesonide (Rhinocort), flunisolide, mometasone (Nasonex), triamcinolone (Nasacort Allergy 24HR), beclomethasone (Beconase AQ) and ciclesonide (Omnaris).
- Oral and injectable corticosteroids. If a nasal corticosteroid isn't effective, your doctor may prescribe an oral corticosteroid, such as prednisone, either alone or in combination with a nasal spray. Because oral corticosteroids can cause serious side effects, you usually take them only for a limited period. Injectable corticosteroids may be used if nasal polyps are severe.
- Other medications. Your doctor may prescribe drugs to treat conditions that contribute to chronic inflammation in your sinuses or nasal passages. These may include antihistamines to treat allergies and antibiotics to treat a chronic or recurring infection. Aspirin desensitization and treatment may benefit some patients with nasal polyps and aspirin sensitivity.
If drug treatment doesn't shrink or eliminate nasal polyps, you may need endoscopic surgery to remove polyps and to correct problems with your sinuses that make them prone to inflammation and polyp development.
In endoscopic surgery, the surgeon inserts a small tube with a magnifying lens or tiny camera (endoscope) into your nostrils and guides it into your sinus cavities. He or she uses tiny instruments to remove polyps and other obstructions that block the flow of fluids from your sinuses.
Your surgeon may also enlarge the openings leading from your sinuses to your nasal passages. Endoscopic surgery is usually performed as an outpatient procedure.
After surgery, you'll likely use a corticosteroid nasal spray to help prevent the recurrence of nasal polyps. Your doctor may also recommend the use of a saltwater (saline) rinse to promote healing after surgery.
Nov. 12, 2016
- Nasal polyps. Merck Manual Professional Version. https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/nose-and-paranasal-sinus-disorders/nasal-polyps. Accessed Sept. 21, 2016.
- Usatine RP, et al. Nasal polyps. In: The Color Atlas of Family Medicine. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2013.
- Diagnosis and treatment of respiratory illness in children and adults. Bloomington, Minn.: Institute for Clinical Systems Improvement. https://www.icsi.org/guidelines__more/catalog_guidelines_and_more/catalog_guidelines/catalog_respiratory_guidelines/respiratory_illness/. Accessed Sept. 21, 2016.
- Kliegman RM, et al. Nasal polyps. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Sept. 21, 2016.
- Adkinson NF, et al. Rhinosinusitis and nasal polyps. In: Middleton's Allergy: Principles and Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. https://www.clinicalkey.com. Accessed Sept. 21, 2016.
- Bhattacharyya N. Clinical presentation, diagnosis, and treatment of nasal obstruction. http://www.uptodate.com/home. Accessed Sept. 21, 2016.
- Sinus rinsing and neti pots. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/naegleria/sinus-rinsing.html Accessed Sept. 22, 2016.