What to Know About Nasal Polyps Removal
Nasal polyps are harmless, fleshy lumps which develop in the mucosa (lining) of the nasal passages. These painless growths usually go unnoticed until they become large enough to obstruct the airflow through the nose. When this happens, the patient will start to experience symptoms of chronic congestion including stuffiness, difficulty breathing through the nose and, eventually, loss of taste and smell. When they start to effect everyday life, nasal polyps removal is needed.
Though medical treatment options are available, many people choose to have their nasal polyps surgically removed. In most cases, nasal polyp surgery is a quick and effective way to permanently remove the growths, and rarely leads to complications.
However, before deciding to undergo any surgical procedure, it is important to learn all you can about the risks, benefits and aftercare advice so you can properly prepare for the treatment.
What Are Nasal Polyps?
Nasal polyps are benign, fleshy, painless lumps that grow in the lining of the nasal cavities (the mucosa). These teardrop-shaped growths are harmless and, if small, often go unnoticed. When they grow too big, however, they can obstruct the nasal passages and cause congestion. If left untreated, this can eventually lead to a permanent loss of smell.
Nasal polyps are thought to affect up to 4% of the general population, though they are usually associated with other long-term, inflammatory disorders affecting the nasal passages.
What Are the Symptoms of Nasal Polyps?
The symptoms of nasal polyps typically include:
- A blocked or stuffy feeling in the nose
- Difficulty breathing through the nose
- A feeling of pressure in the face or forehead
- Pain in the face or upper teeth
- Diminished sense of smell
- Diminished sense of taste
- A runny nose
- Postnasal drip (where mucus builds up and runs down the back of the throat)
- Unexplained snoring
If you think you may have nasal polyps, schedule an appointment with your doctor, who will be able to diagnose you with a simple visual examination of your nasal passages.
What Causes Nasal Polyps?
Nasal polyps are common and can affect anyone, of any gender, at any age. However, they are most often associated with long-term inflammation of the nasal passages and are usually diagnosed in people with cystic fibrosis, persistent asthma, aspirin-exacerbated respiratory disease (AERD) and chronic rhinosinusitis (CRS).
Other factors that put you at higher risk of developing nasal polyps include:
- Recurrent respiratory infections
- Allergies to certain medications, such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
- Chronic pollen allergies (chronic rhinitis)
- Age (adults are far more likely to develop nasal polyps than children)
Medical Treatment Options for Nasal Polyps
Many people have surgery to remove their nasal polyps, but your doctor will probably recommend that you try pharmacological treatment for at least a month first. This usually involves topical medications containing steroidal drugs (like fluticasone, budesonide or mometasone) which are applied using a nasal spray or drops. In many cases, these will effectively shrink the growths and ease congestive symptoms.
If topical steroids don’t work, your doctor may prescribe systemic steroids, which are taken in pill form. This is also recommended in cases where the nasal polyps are large and advanced.
Surgical Treatment Options for Nasal Polyps
If medical treatment proves unsuccessful, your doctor may recommend that you have your nasal polyps removed surgically.
Endoscopic sinus surgery (ESS) is the preferred surgical treatment for the removal of nasal polyps. During the procedure, the doctor will insert a thin, flexible instrument called an endoscope into the nose. The endoscope, equipped with a tiny set of tools and camera, is then used to cut away the nasal polyps.
ESS is generally considered to have a higher success rate than the simpler polypectomy, with over 90% of patients experiencing an improvement in their symptoms and quality of life after having the surgery. However, regrowth of nasal polyps is likely after ESS, with one study finding that the polyps grew back in 60% to 70% of patients within 18 months of treatment.
Benefits of Surgical Treatment
One of the biggest reasons to have your nasal polyps surgically removed is to preserve your sense of smell. This is often diminished in people with nasal polyps and can be lost permanently if the polyps are not removed.
Nasal polyp surgery can also significantly reduce other symptoms including stuffiness, headaches and difficulty breathing. The majority of people who have nasal polyp surgery report significant improvements to their quality of life, especially with regards to the alleviation of headaches and stuffiness.
Possible Risks From Nasal Polyps Surgery
Nasal polyp surgery is safe for most people, but no medical procedure is 100% risk-free. It’s important to be aware of all the risks associated with nasal polyp surgery before you commit, so you can make an informed decision based on your needs and expectations. These are some possible complications:
- Blockage. You will probably have dried blood and scabs forming inside your nose immediately after your surgery, which can block your nose. This is a common side-effect of the procedure but usually clears up within a few weeks.
- Bleeding. A little bleeding is normal after nasal polyp surgery.
- Regrowth. Having your nasal polyps surgically removed may not be a permanent fix; in fact, regrowth is seen in up to 70% of cases within 18 months of surgery.
- Infections. Inflammation in the sinuses after surgery may slightly increase your risk of infection.
- Injury to the eye. Many parts of your nasal passages are separated from your eye by just a very thin piece of bone. Therefore, there is a very small risk that nasal polyp surgery could result in injury to the eye.
- Loss of sense of smell. Nasal polyps are known to cause a loss of sense of smell and, in most cases, surgical treatment helps to restore it. Very rarely, however, the surgery can cause further loss of sense of smell.
After-Care Treatment for Nasal Polyp Surgery
Your doctor may prescribe a course of post-operative steroids after your nasal polyp surgery, as this has been found to further improve symptoms and reduce the risk of regrowth. In some cases (i.e. if you had an infection prior to the surgery) antibiotics may also be recommended.
Other follow-up care tips for nasal polyp surgery include:
- Arrange to have someone drive you home after
- Avoid blowing your nose for four to seven days after you have the surgery
- Rest for at least five days after surgery before resuming your usual daily activities
- Avoid any activities that could raise your blood pressure (such as heavy lifting or running) until you get the green light from your doctor to do so
- Follow wound care (regarding nasal packing and use of topical medications) as directed by your doctor
Endoscopic sinus surgery (ESS) is the go-to surgical treatment for nasal polyps. During this treatment, the doctor will insert a thin, flexible instrument with a tiny camera and tools at the end into your nasal cavity. This is used to cut away the nasal polyps, opening up the airways and reducing the symptoms of congestion. Nasal polyp surgery is safe for most people, and the majority of those who have it are satisfied with the results and report an improved overall quality of life. However, surgery may not be a permanent fix, as polyps have been found to grow back in 60-70% of patients within 18 months of the procedure.