What are nasal polyps?

Nasal polyps are abnormal, soft, swollen, sac-like growths of inflamed tissue. They line the inside of your nose or your sinuses.

The sinuses are a group of air-filled spaces inside the bones of your face. They connect with the nasal cavity. This is the large, air-filled space behind your nose. Normally these spaces are fairly open, but nasal polyps can grow large enough to block them. This can cause trouble breathing.

Nasal polyps are a subgroup of chronic rhinosinusitis. This is a condition where the nasal cavity and sinuses are inflamed for more than 4 to 12 weeks. But not all people with this condition will develop nasal polyps.

Other types of growths sometimes form in the nasal cavity. Some of these types may be cancer. But true nasal polyps are not cancer.

Nasal polyps are fairly common. Anyone can have them.

What causes nasal polyps?

Researchers are still learning about the causes of nasal polyps. Underlying inflammation of your tissue plays some sort of role. Nasal polyps are more common in people with these health conditions:

• Asthma

• Aspirin sensitivity

• Chronic sinus infections

• Cystic fibrosis

• Hay fever (allergic rhinitis)

Certain genes may also help lead to the development of nasal polyps. This is especially true of genes that play a role in the immune system and inflammatory response. You may be more likely to have nasal polyps if other members of your family have had them.

What are the symptoms of nasal polyps?

If you have nasal polyps, you may feel like you have a cold for months or longer. Some of your symptoms may be due to the nasal polyps. Others may result from the chronic rhinosinusitis that caused your polyps.

The most common symptoms of nasal polyps include:

• Stuffy nose (nasal congestion)

• Runny nose

• Facial sinus fullness (but usually not pain)

• Postnasal drip

• Reduced sense of smell

• Feeling blocked in your nose and having to breathe through your mouth

Unless you also have an infection, you shouldn’t have symptoms, such as fever or yellowish or greenish drainage from the nose. Complications from nasal polyps may cause additional symptoms.

The symptoms of nasal polyps may seem like other health conditions or problems. Always see your healthcare provider for more information.

How are nasal polyps diagnosed?

Diagnosis begins with a complete health history and physical exam. Your healthcare provider will examine your nose. They may be able to see your polyps with a simple lighted tool.

Your provider might need more information about your sinuses and nasal cavity. They might try to diagnose the specific trigger of your polyps, such as certain allergies. You might need tests, such as:

• Nasal endoscopy. Your provider places a thin flexible tube into your nose. The tube has a camera and light on the end. This gives a detailed view of your inner nose and your sinuses.

• CT scan. This is done if the diagnosis isn’t clear. X-rays pass through your nose and create detailed images that are analyzed by a computer.

• MRI scan. This is done if more imaging is needed. An MRI machine uses a magnetic field and radio waves to make an image of structures inside your body without the use of X-rays.

• Allergy testing. This is done to diagnose allergies.

• Additional tests. Other tests may be done to diagnose the area and airflow of the nasal cavity.

• Polyp biopsy. This is often only done if needed to rule out a cancerous growth. Your healthcare provider removes your polyp, or takes a sample. It is tested to see if it is cancer.

A healthcare provider who is a general practitioner might first diagnose you. Many people with nasal polyps will eventually need to see an ear, nose, and throat specialist (ENT or otolaryngologist).

How are nasal polyps treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment aims to reduce inflammation, as well as the size of your polyps. Healthcare providers often start treatment with steroid medicines breathed in (inhaled) through the nose. These medicines can decrease the inflammation at the root of the problem. People who don’t respond to this might need steroid medicines taken by mouth.

Other treatments for nasal polyps include:

• Medicines to help decrease inflammation (antileukotrienes)

• Antibiotics for possible infection

• Nasal steroid sprays

• Daily rinsing of the sinuses with a saltwater solution

• Antihistamines to reduce allergic reactions

• Allergen immunotherapy and removal of allergens, if possible

• Aspirin desensitization therapy, if appropriate

• A biologic medicine called dupilumab given as a shot (injection) every other week

You may still have symptoms despite these other therapies. If this is the case, surgery may help. Surgery does often get rid of most symptoms. But the polyps may come back within a few months to a few years. It is important to address the underlying cause of your nasal polyps to help prevent this from happening. After your surgery, you may need to take inhaled nasal steroids to help keep the polyps from returning.

What are possible complications of nasal polyps?

Nasal polyps sometimes cause problems. Sinus infections are common complications. These infections may come back often and become long-lasting (chronic). If you get a bacterial infection, you may need treatment with antibiotics.

Less commonly, nasal polyps cause problems from more dangerous infections, such as:

• Infection of the tissue around the brain and spinal cord (meningitis)

• Infection around the tissue around the eye (orbital cellulitis)

• Infection of the sinus bones (osteitis)

Your healthcare provider will watch your symptoms carefully to make sure you don’t have these problems. If you have one of these complications, you might need antibiotics. In very rare cases, you might need surgery as well.

Very large nasal polyps can also sometimes block your nasal passageway during sleep. This is called obstructive sleep apnea. This might make you very tired and drowsy the next day. It’s important to let your healthcare provider know if this is one of your symptoms.

What can I do to prevent nasal polyps?

No one knows how to prevent nasal polyps from first forming. Therapy aimed at the cause can help keep your polyps in check. It may also help prevent them from coming back if you have had surgery. Following all your healthcare provider’s treatment instructions can help.

When should I call my healthcare provider?

Call your healthcare provider if your symptoms don’t get better with a few days of treatment. Also call or get medical care right away if you have any signs of possible problems, such as:

• Abnormal vision

• Swelling around your eyes

• Confusion or loss of alertness

Key points about nasal polyps

• Nasal polyps are soft, swollen, sac-like growths of inflamed tissue. They line the inside of your nose or your sinuses.

• They are a type of chronic rhinosinusitis. This is an inflammation of the nasal cavity and sinuses.

• True nasal polyps are not cancer.

• Certain health conditions are more common in people with nasal polyps. These include asthma and aspirin sensitivity.

• Medicines and staying away from allergens may help decrease your symptoms. Surgery may also be needed to remove your polyps.

• Nasal polyps sometimes cause rare and serious problems, such as meningitis.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.