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What are nasal polyps?

Nasal polyps typically painless growths within the nasal airway or sinuses. The primary symptoms caused by these polyps include chronic nasal congestion, nasal obstruction, and reduced or absent sense of smell. 

What causes nasal polyps?

The causes of nasal polyps are not completely understood. Various factors may play a role, including defects of the nasal airway surface, increased exposure to nasal bacteria, and dysregulation of immune system responses; these factors are thought to cause recurrent inflammation due to increased immune reactions. Polyps caused by type 2 immune reactions tend to have the most severe symptoms and disease progression. Nasal polyps are more likely to occur in patients with persistent asthma, chronic rhinosinusitis (CRS), cystic fibrosis, and aspirin-exacerbated respiratory disease (AERD). 

How do I treat nasal polyps?

The current recommended treatment for nasal polyps is a topical nasal steroid (sprays, irrigations, etc.). They work to reduce polyp size and nasal congestion/drainage, which in turn increases nasal airflow. Short-term oral steroids may be needed initially, followed by long-term treatment with a topical steroid. Surgery may be needed to remove polyps for patients with recurrent nasal sinus inflammation, severe nasal obstruction, or who have failed therapy with oral and topical steroids. For patients experiencing severe nasal polyps due to type 2 immune reactions, injectable biologic medications may be considered for treatment.

FAQs

How do I find out if I have nasal polyps?

Usually, doctors will be able to diagnose nasal polyps by looking into your nose with a light. Occasionally, CT scans are used to obtain imaging of a patient’s nose and sinuses.

Is there anything I can do on my own?

Some patients can relieve symptoms with at-home nasal saline rinses. There are a variety of nasal irrigation devices available over the counter at drug stores. Note that saline rinses will not cure nasal polyps, but only provide symptomatic relief.

Cassie Surber, PharmD Candidate

Marshall University Pharmacy School

Resources

  1. Bachert C, Han JK, Wagenmann M, et al. EUFOREA expert board meeting on uncontrolled severe chronic rhinosinusitis with nasal polyps (CRSwNP) and biologics: Definitions and management [published correction appears in J Allergy Clin Immunol. 2021 May;147(5):1981-1982]. J Allergy Clin Immunol. 2021;147(1):29-36. doi:10.1016/j.jaci.2020.11.013
  2. Georgy MS, Peters AT. Chapter 7: Nasal polyps. Allergy Asthma Proc. 2012;33 Suppl 1:22-23. doi:10.2500/aap.2012.33.3537

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