Nasal polyps and other nasal obstructions
Polyps and other obstructions within a nasal passage can block a nose, possibly making it more difficult to breathe. Nasal polyps are a common problem, but another type of growth, or a deviated nasal septum, can also block a nasal passage.
What are nasal polyps?
The lining inside the nasal passages and sinuses can become inflamed, forming swellings with the appearance of small grape-like growths known as polyps. These polyps vary in size and can appear alone or in clusters, but they often occur in both nostrils. The polyps are swollen with inflammatory fluid that may be associated with allergy, asthma and infection.
Nasal polyps often occur in people who also have asthma that only developed in adulthood or who have cystic fibrosis or aspirin intolerance. Asthma is present in 20-40% of people with polyps. Fewer than one third of people with polyps have evidence of systemic allergies, but in 90% of cases, people with nasal polyps have inflammatory cells that are linked to allergy.
Men are more likely to have nasal polyps than women, but the likelihood of developing them declines in people 60 years old and over. If a child has a nasal polyp, he or she should be checked for cystic fibrosis, as 50% of people with cystic fibrosis have nasal polyps.
What are the symptoms of nasal polyps?
Small nasal polyps may cause no symptoms at all. However, nasal polyps can cause a blocked nose, and a runny nose, with or without sneezing, occurs in about half of people with them. You may have a post-nasal drip, mucus that drips down your throat. These symptoms are also similar to those of a cold, but while the symptoms of a cold are temporary, those of nasal polyps will continue. If you experience these symptoms for a month or longer, you should seek medical advice.
Nasal polyps can also affect a person's sense of smell and taste, which may remain altered even after treatment. If the polyps are large enough, they can cause snoring or obstructive sleep apnoea. A high fever, toothache and facial pain may indicate polyps that are blocking the sinuses and causing sinusitis.
How are nasal polyps treated?
The inside of the nose may be examined with an endoscope, a small tube with a camera on one end, to rule out an infection or other irregularities.
Corticosteroids are often used to shrink the size of nasal polyps and can be provided in several forms:
Nasal drops: These tend to work faster than nasal sprays. However, they are used for a limited period of up to 2 weeks, because they can cause side effects and some of the corticosteroid may be absorbed into the body.
Nasal sprays: It may take up to 6 weeks before the polyps shrink, but steroids provided in nasal sprays can be used long term over a number of years because they have less risk of side effects and less risk of being absorbed into the body.