Polys are abnormal painless growth from the mucosal surface which can occur on any part of our body: in the nasal cavity, intestinal tract and female reproductive system. Polyps are usually not associated with morbid outcomes as statistically proven five-year relative survival is 54.5%. Depending on the type, size and location of the polyp, patients will present with different complaints to the doctors, including disturbance in the nervous system characterized by headaches or visual disturbance. Hence, do book appointments by DoctoronCall for your medical check-up with the nearest specialist which can be arranged at your own convenience.
How to know if I have nasal polyp?
Small polyps do not usually cause bothersome symptoms to patients and are an incidental finding for less serious conditions. On the other hand, larger nasal polyp can resemble a case of sinusitis which is an infection of the sinus characterized by:
- Nasal airway obstruction
- Mucus draining at the back of the throat
- Dull headaches
- Rhinorrhea or runny nose.
Associated symptoms that will arouse suspicion of an underlying alarming condition are snoring and hyposmia or anosmia. It may be a clue that it was not merely the presence of chronic sinusitis alone but possibly a polyp as well. Epistaxis usually doesn’t occur unless the abnormal growth is in the anterior nasal septum as the area is particularly rich with blood supply.
If the polyp is large enough and is located at the posterior end of the nasal cavity (antral-choanal polyp) it is able to cause obstruction to the nasopharynx. Consequently, patients with this type of polyp will suffer from obstructive sleep symptoms and chronic mouth breathing.
In rare occasions, massive polyposis can lead to compression on the optic nerve bringing about the visual disturbance.
What is the treatment for nasal polyp?
Before a decision is to be made regarding the removal of a nasal polyp, the patient’s nasal cavity must first be examined. Investigative procedures involved are:
- Nasal endoscopy: a long thin tube containing a small camera will be inserted to examine the nasal cavity more clearly. Its length also allows better examination of the internal part of the nasal cavity which is not easily seen.
- Biopsy: For suspected growth seen from nasal endoscopy, a tissue sample is taken for microscopic examination.
- CT or MRI scan: This procedure is done ONLY after the patient has a confirmed diagnosis of sinus cancer for the purpose of staging and surgical planning. This is because unnecessary exposure to radiation by these machines is not recommended.
Consultation with multiple specialities should be considered because the polyps may involve complex structures throughout the face.
Once confirmed, the polyp can be managed medically or surgically:
- Pharmacologic treatment
Oral and topical nasal steroid administration is the primary medical therapy for nasal polyposis. It helps to reduce inflammation and in inhibiting further growth.
Long- term topical nasal steroid is preferred as adverse effects such as growth retardation, diabetes mellitus, hypertension, psychotropic effects, adverse GI effects etc. mostly occurs with oral route.
Symptomatic relief is provided by administering antihistamines, decongestants, and cromolyn sodium whereas an antibiotic is needed if the bacterial infection is present.
Surgical removal of a nasal polyp is indicated in:
– Children with multiple benign nasal polyposes.
– Chronic rhinosinusitis is unresponsive to maximal medical therapy.
– In benign multiple nasal polyposes, removal of polyps will cause high recurrence rate instead.
Postoperative follow-up should occur in the first month to monitor the healing of the sinus cavities. Frequency of follow-up depends on the patient’s own geographic location and symptoms. Long- term monitoring is reserved for children with benign multiple nasal polyps because there’s a high chance of recurrence.