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Nasal polyps

What are nasal polyps?

These are grape like growths from the sinuses that hang into the nasal cavity. They represent an intense inflammation of the sinus lining.

What are its causes?

Infection, allergy, and abnormal anatomy can all play a role in their development much the same as in sinusitis. The inflammatory process is very similar to that seen in bronchial airways of asthmatics. Indeed, 10-15% of patients with nasal polyps have asthma. Another association is an ‘allergy’ type of reaction to aspirin or aspirin like drugs called non-steroidal anti-inflammatory drugs (NSAIDs).

What symptoms do they cause?

At first nasal polyps may be restricted to a small area of the nose, but as they grow, nasal breathing is restricted giving rise to blockage. One prominent symptom of this condition is reduced or loss of smell sense. Nasal polyps block the normal drainage pathways from the sinuses, and can cause all the symptoms mentioned in sinusitis.

How are they managed?

Examination with an endoscope is essential to confirm their presence. Investigations such as a CT scan are used to evaluate the extent of sinus involvement.

There is no permanent cure for nasal polyps. Their growth can be restricted by medication. However, medication needs to be used long term as in asthma to control progression. If the polyps are large and do not respond to medication surgical removal is required. However, it is essential that patients continue to use medication after surgery to prevent a swift recurrence of the problem. Medication will delay re-growth, and also the number of operations.

Nasal polyps are graded depending on their size. These are grade II.
Grade III nasal polyps occupying the whole nasal cavity.
Nasal blockage is a symptom of nasal polyps.
Anosmia or hyposmia is a hallmark symptom of nasal polyps.
CT scan of the sinsues provided information on the extent of disease, and is used for guidance during FESS.
Nasal polyps
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