Nasal Polyps: Overview of Causes and Available Treatments

Causes and Risk Factors of Nasal Polyps

The exact cause of nasal polyps is not fully understood, but they are closely associated with inflammation of the mucous membrane lining the sinuses and nasal passages. This chronic inflammation results in fluid accumulation in the cells of the membrane which eventually turns into a polyp. Although anyone can develop nasal polyps, they are more frequently observed in adults. Studies suggest that people with certain conditions are at a higher risk:

• Asthma: Approximately 7% of all asthma sufferers develop nasal polyps.
• Aspirin Sensitivity: Up to 40% of adults with nasal polyps have an associated aspirin intolerance.
• Allergic Fungal Sinusitis: This allergic reaction to airborne fungi is common among polyp sufferers.
• Cystic Fibrosis: This genetic disorder that affects the lungs and other organs can lead to the development of nasal polyps, especially in younger patients.
• Chronic Sinusitis: Long-term inflammation of sinuses heightens the chances of polyp formation.

Symptoms of Nasal Polyps

The presence of nasal polyps often leads to symptoms that can interrupt daily activities and reduce the quality of life. They include:

• Nasal Congestion: Frequent and persistent stuffiness is the most common symptom.
• Postnasal Drip: A sensation of mucus continually running down the back of the throat.
• Constant Runny Nose: The nose produces a fluid that can be clear, thin or thick and colored.
• Facial Pain or Pressure: Overlying areas can be tender to the touch and the pressure may increase with the increase in polyp size.
• Loss of Smell and Taste: As nasal passages become clogged, sensory dysfunction can occur.

Diagnostic Approaches

Diagnosing nasal polyps involves a range of approaches as the symptoms can overlap with other nasal conditions. Typically, the process includes:

• Endoscopic Exam: A narrow tube with a camera at the end is inserted into the nasal passages to provide a detailed view of the sinuses.
• Imaging Studies: CT scans can help determine the presence and size of polyps, as well as the extent of inflammation.
• Allergy Tests: Conducted to identify substances triggering allergic reactions which may contribute to chronic sinusitis and polyp formation.
• Sensitivity Tests: Especially to NSAIDs like aspirin which can exacerbate polyp-related inflammation.

Treatment Options for Nasal Polyps

The treatment of nasal polyps usually involves medication to shrink the polyps or surgery to remove them, though often they can recur after treatment. The mainstay treatment approaches include:

• Steroids: Topical nasal steroids such as fluticasone, budesonide, and mometasone often reduce the size of the polyps and alleviate symptoms. Sometimes, oral steroids may be prescribed for severe cases.
• Surgery: For large or resistant polyps, a procedure called endoscopic sinus surgery may be necessary to remove the polyps and widen the areas around the nasal passages to help drain the sinuses.
• Biologic Therapies: Recently, drugs like dupilumab have been approved for use in patients with severe cases of nasal polyps and comorbid conditions such as asthma. These biologics target specific pathways involved in inflammation and have shown benefits in reducing polyp size and symptoms.
• Management of Associated Conditions: Effective management of conditions like asthma, allergic rhinitis, and aspirin sensitivity can help alleviate the intensity of polyp symptoms and prevent recurrences.

Conclusion

Nasal polyps can be a troublesome condition leading to chronic symptoms that impact daily living and overall health. With advances in medical treatments and surgical techniques, many patients find effective relief from their symptoms. However, due to the possibility of recurrence, long-term medical management may be necessary. It is crucial for individuals suffering from this condition to engage in regular follow-ups with their healthcare provider to manage the condition effectively over time.