Nasal Polyps – Diagnosis and Treatment
Diagnosis
Doctors start by asking about symptoms like nasal congestion, runny nose, decreased sense of smell, facial pain, postnasal drip, and headaches. They also review your personal and family medical history, especially for asthma, allergic rhinitis, and cystic fibrosis.
Doctors perform a physical exam of the nose. If they suspect polyps, they often use a nasal endoscopy. A nasal endoscopy uses a thin tube with a camera. This tool helps doctors look for noncancerous growths inside your nasal passages.
Doctors may order imaging tests like CT scans. These tests show where the polyps are and how big they have grown.
Imaging also helps doctors find out if sinusitis or other causes of nasal blockage are present. They sometimes use allergy tests to check for allergens that might cause chronic inflammation.
Allergy testing can be a skin prick test or a blood test. Blood tests look for eosinophils or other allergy markers.
When children have nasal polyps, doctors might suggest a sweat test to check for cystic fibrosis. Blood tests can also help find other medical issues.
Below is a summary of ways doctors diagnose nasal polyps:
| Test | What it Detects |
|---|---|
| Physical Exam | Signs of polyps, inflammation |
| Nasal Endoscopy | Location/size of polyps |
| CT Scan | Extent and location of polyps |
| Allergy Tests | Triggers for inflammation |
| Sweat Test | Cystic fibrosis |
| Blood Tests | Immune or allergy problems |
These steps help doctors find the cause of symptoms and plan treatment.
Treatment
Medicine Choices
Doctors usually start treatment for chronic sinus issues with medicines. Nasal sprays containing steroids are a common choice. These sprays help lower swelling and shrink polyps.
Sometimes, nasal sprays do not reach all polyps. In these cases, doctors may give oral steroids for a short time.
Doctors might also give oral steroids before surgery to help reduce the size of polyps. If polyps are severe, a steroid shot may be used, but pills and shots can cause strong side effects, so doctors use them carefully.
For patients with polyps that come back or do not get better with standard care, doctors may use biologic drugs.
These medicines block certain cells or proteins that cause swelling in the nasal passages. Other medicines can help treat triggers that cause swelling in the nose.
Doctors give antihistamines to people with allergies. They prescribe antibiotics if an infection is present.
For some people with both nasal polyps and asthma, an allergy specialist may try aspirin desensitization. This process helps patients build up tolerance to aspirin and requires close medical supervision.
Example of Medicine Options
| Type of Medicine | Purpose |
|---|---|
| Nasal steroids | Reduce swelling, shrink polyps |
| Oral steroids | Shrink severe or hard-to-reach polyps |
| Biologics | Treat stubborn, recurring polyps |
| Antihistamines | Manage allergies |
| Antibiotics | Treat infection if present |
Tip: Regular follow-up with your doctor is important to check if the polyps return or if you need new treatment.
Polyp Removal Methods
If medicines do not work or polyps return, doctors may recommend surgical treatment. The main operation is endoscopic sinus surgery.
In this procedure, a surgeon uses a thin tube with a camera (endoscope) to look inside the nose and sinuses. The surgeon uses small tools to remove the polyps and widen sinus openings if needed.
A related method is balloon dilation. This technique opens up the sinus passages using a small balloon without removing tissue.
After surgery, doctors suggest using nasal sprays such as corticosteroids to keep polyps from coming back. A device may be placed inside the nose to slowly release steroids and reduce swelling.
A saltwater rinse is often helpful for healing after surgery. Regular doctor visits help ensure the nose and sinuses heal well and allow early detection if polyps return.
Getting Ready for Your Visit
How You Can Prepare
Bring a family member or friend with you to your appointment. They can help you remember what the doctor says and support you.
Make a list before your visit:
- All Your Symptoms: Include everything, even if it does not seem related to your nose or sinuses. Write down when each symptom started.
- Medical History: Note any other health problems you have.
- Medications, Vitamins, and Supplements: Record what you take and the exact doses.
- Questions for the Doctor: Write down anything you want to know and bring this list with you.
Useful questions to consider:
| Question Topic | Example Question |
|---|---|
| Cause of symptoms | What do you think is causing my symptoms? |
| Needed tests | What kinds of tests will I need? |
| Treatment options | What treatments do you suggest? |
| Referral | Do I need to visit an ENT specialist? |
What Your Healthcare Provider May Discuss
The doctor or otolaryngologist will likely ask about the last time you had a cold or sinus infection. They may also ask how often you get these infections.
Your provider may ask about allergies and what triggers them. They might want to know if you have asthma and how well you manage it.
They could ask if you use pain medicines like aspirin regularly. Your provider may also ask if you are exposed to tobacco smoke, either by smoking or from others.
They may ask about your work and hobbies. Your provider might want to know if you have had any past nasal or sinus surgeries.
If you prepare your answers ahead of time, you help your provider understand your situation. This makes it easier for them to choose the best next steps for your care.
