Nasal polyps

Overview

Nasal polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They hang down like teardrops or grapes. They result from chronic inflammation and are associated with asthma, recurring infection, allergies, drug sensitivity or certain immune disorders.

Small nasal polyps may not cause symptoms. Larger growths or groups of nasal polyps can block your nasal passages or lead to breathing problems, a lost sense of smell and frequent infections.

Nasal polyps can affect anyone, but they're more common in adults. Medications can often shrink or eliminate nasal polyps, but surgery is sometimes needed to remove them. Even after successful treatment, nasal polyps often return.

Symptoms

Nasal polyps are associated with irritation and swelling (inflammation) of the lining of your nasal passages and sinuses that lasts more than 12 weeks (chronic sinusitis).

However, it's possible to have chronic sinusitis without nasal polyps.

Nasal polyps themselves are soft and lack sensation, so if they're small, you may not be aware you have them. Multiple growths or a large polyp may block your nasal passages and sinuses.

Common signs and symptoms of chronic sinusitis with nasal polyps include:

• A runny nose
• Persistent stuffiness
• Postnasal drip
• Decreased or absent sense of smell
• Loss of sense of taste
• Facial pain or headache
• Pain in your upper teeth
• A sense of pressure over your forehead and face
• Snoring
• Frequent nosebleeds

When to see a doctor

See your doctor if your symptoms last more than 10 days. Symptoms of chronic sinusitis and nasal polyps are similar to those of many other conditions, including the common cold.

Seek immediate medical care or call 911 or your local emergency number if you experience:

• Serious trouble breathing
• Sudden worsening of your symptoms
• Double vision, reduced vision or limited ability to move your eyes
• Severe swelling around your eyes
• Increasingly severe headache accompanied by high fever or inability to tip your head forward

Causes

Scientists don't yet fully understand what causes nasal polyps, why some people develop long-term inflammation, or why irritation and swelling (inflammation) triggers polyps to form in some people and not in others. The swelling occurs in the fluid-producing lining (mucous membrane) of your nose and sinuses.

There's some evidence that people who develop polyps have different immune system responses and different chemical markers in their mucous membranes than do those who don't develop polyps.

Nasal polyps can form at any age, but they're most common in young and middle-aged adults.

Nasal polyps may form anywhere in your sinuses or nasal passages, but they appear most often in an area where sinuses near your eyes, nose and cheekbones all drain through winding passages into your nose.

Risk factors

Any condition that triggers long-term irritation and swelling (inflammation) in your nasal passages or sinuses, such as infections or allergies, may increase your risk of developing nasal polyps.

Conditions often associated with nasal polyps include:

• Asthma, a disease that causes the airway to swell (inflame) and narrow
• Aspirin sensitivity
• Allergic fungal sinusitis, an allergy to airborne fungi
• Cystic fibrosis, a genetic disorder that results in abnormally thick, sticky fluids in the body, including thick mucus from nasal and sinus linings
• Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis), a rare disease that causes the inflammation of blood vessels
• Vitamin D deficiency, which occurs when your body doesn't have enough vitamin D

Your family history also may play a role. There's some evidence that certain genetic variations associated with immune system function make you more likely to develop nasal polyps.

Complications

Nasal polyps can cause complications because they block normal airflow and fluid drainage, and also because of the long-term irritation and swelling (inflammation) underlying their development.

Potential complications include:

• Obstructive sleep apnea. This is a potentially serious condition in which you stop and start breathing frequently during sleep.
• Asthma flare-ups. Chronic sinusitis can worsen asthma.
• Sinus infections. Nasal polyps can make you more susceptible to sinus infections that recur often.

Prevention

You may help reduce your chances of developing nasal polyps or having nasal polyps recur after treatment with the following strategies:

• Manage allergies and asthma. Follow your doctor's treatment recommendations. If your symptoms aren't well controlled, talk to your doctor about changing your treatment plan.
• Avoid nasal irritants. As much as possible, avoid breathing airborne substances that are likely to contribute to swelling or irritation in your nose and sinuses, such as allergens, tobacco smoke, chemical fumes, and dust and fine debris.
• Practice good hygiene. Wash your hands regularly and thoroughly. This is one of the best ways to protect against bacterial and viral infections that can cause inflammation of the nasal passages and sinuses.
• Humidify your home. Using a humidifier may help moisten your breathing passages, improve the flow of mucus from your sinuses, and help prevent blockages and inflammation. Clean the humidifier daily to prevent bacteria from growing.

• Use a nasal rinse. Use a saltwater (saline) spray or nasal wash to rinse your nasal passages. This may improve mucus flow and remove allergens and other irritants.

  You can purchase over-the-counter saline sprays or nasal wash kits with devices, such as a neti pot or squeeze bottle, to administer a rinse.

  Use water that's distilled, sterile, previously boiled for one minute and cooled, or filtered using a filter with an absolute pore size of 1 micron or smaller to make up the irrigation solution. Rinse the irrigation device after each use with the distilled, sterile, previously boiled, or filtered water and leave it open to air-dry.