Nasal Polyps Part 2
Symptoms and Treatment

The number and size of growths covered in nasal polyps part 2 may eventually increase. Consequently, polyp clusters or large growths will obstruct the nasal passages causing some nasty symptoms:

· Difficulty in breathing through the nose and constant stuffiness.

· Postnasal drip (mucus discharge via the back of the throat).

· Runny nose.

· Persistent symptoms of a common cold.

· Impaired or loss of the sense of smell and taste.

· Facial swelling, sometimes followed by double vision.

· Facial pain leading to a sinus headache.

· Itching around the eyes.

· Snoring. Sometimes followed by sleep apnea (patient stops breathing for extended periods during the night). This condition could be dangerous.

· Frequent sinus infection. Nasal polyps obstruct mucus drainage, and this inevitably causes infection. This damming effect creates stagnant pools of mucus inside the sinus cavities... and this is a natural breeding ground for fungi, bacteria and viruses.

Please note: People with small polyps are often asymptomatic (experience no noticeable symptoms).

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Diagnosis

Whereas nasal polyps are fairly easy to diagnose, without first identifying the root cause and then following up with targeted treatment, medication or surgical removal could be a waste of time and money.

Why? Because in high percentage of cases, sinus polyps have a tendency to grow back within a relatively short time – unless they are nipped in the bud.

When you first present your complaint to your doctor, s/he will ask a number of questions and then follow up with a physical examination of your nose.

Nasal polyps are often detected by simply shining a light up the nostril. If they are deeply embedded, however, s/he will use an instrument called an "nasopharyngoscope." This is a thin, flexible fiberoptic instrument used to examine the nasal passages to identify the frequency, size and location of polyp growths.

Once identified, the physician will either refer you to an Ear, Nose & Throat (ENT) specialist, or conduct the following tests designed to isolate and treat the underlying causes:

Computerized tomography (CT) scan: This is a three-dimensional X-ray used to produce a clear image of the nasal cavities. The images identify the exact size and location of any polyps present, together with any other abnormalities such as a deviated septum (crooked nasal passage), nasal tumors, or foreign objects causing obstruction.

Allergy tests: A qualified Allergist should conduct these tests. S/he will carry out skin prick tests on your forearms or upper back using drops of known allergens to identify possible causes of nasal inflammation.

Blood tests: If the skin prick tests are inconclusive, a laboratory blood test may be recommended to screen for specific antibodies tht respond to known allergens.

Tests for cystic fibrosis: If the patient is a child, this test is essential. Cystic fibrosis is a genetic abnormality that causes the overproduction of mucus; and this often leads to nasal growths. This is a non-invasive sweat test that measures the levels of chloride and sodium in the child’s perspiration.

Fungal colonization tests.

Tests for fungi are expensive and often produce false negatives; however, in most cases, an experienced physician is able to identify symptoms of fungal allergies without conducting elaborate tests.

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Medication

One or more of the following drug treatments may be recommended:

Nasal corticosteroid spray: These medications are highly targeted and carry few, if any harmful side effects associated with steroids. They are designed to reduce inflammation, shrink polyps and sometimes eliminate them altogether.

Oral corticosteroids: If nasal corticosteroids are ineffective, a brief course of oral corticosteroids may be recommended, either instead of or as a supplement to nasal steroids.

However, due to harmful side effects, this treatment should never be given for a period exceeding one week.

Side effects include ailments such as hyperglycemia, insulin resistance, and bone loss leading to osteoporosis, to name just a few. As an alternative, your doctor may recommend a corticosteroid injection instead.
Nonsedating antihistamine: Your doctor may prescribe a a specialized antihistamine such as Allegra 180 mg q, or Claritin 10 mg qd to control inflammation caused by allergies.

Fungicidal medication: if symptoms of fungal allergies were detected.

Chronic bacterial sinusitis may call for extended treatment with antibiotics.

Please note: Clinical studies carried out between 2001 and 2007 by the Journal of Pakistan Medical Association, proved that in a large percentage of nasal polyps sufferers, applying the above medication is a complete waste of time and money – because the sinus polyps simply grow back within a few short months.

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Surgery

If medications are ineffective and fail to shrink or eliminate the polyps, your doctor may refer you to an ENT specialist.

If frontal sinus surgery is called for, the options include:

Polypectomy. A small mechanical suction instrument called a "Microdebrider" is used to remove small isolated clusters of polyps. This procedure is often carried out on an outpatient basis.

Endoscopic sinus surgery. During surgery, the ENT would carry out a sinus drainage procedure by opening the osteomeatal complex (this is a series of tubes connecting the nasal passage to the sinus cavities). At the same time s/he would straighten a crooked septum if necessary, and finally, the surgeon would remove any obstructive polyps.

After surgery, you'll likely use a corticosteroid nasal spray to help prevent the recurrence of nasal polyps. Your doctor may also recommend a regular saltwater rinse or sinus flush in order to promote healing after surgery

Please note: As described above, Clinical studies proved that whether nasal polyps are treated by medication or surgery, in many cases the sinus polyps simply grow back within a relatively short time. (See Nasal Polyps Part 3).