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Nasal polyps are swellings that arise from normal mucosa that line our nasal passages. While small ones may not cause any symptoms or require treatment, larger ones may cause problems, such as obstruction to breathing or to the sinus drainage pathways (sinusitis).

Nasal polyps often occur on both sides of the nasal cavity and most of them are benign. If nasal polyps are seen only in one nostril, your doctor may recommend a biopsy to rule out more serious causes.

Causes

Unfortunately, the exact cause is not known and it is not clear why nasal polyps affect some but not others.

Nonetheless, associated conditions include:

  1. Asthma
  2. Aspirin sensitivity
  3. Exposure to chemical fumes and irritants
Potential Complications

If left untreated, nasal polyps can enlarge and cause the following:

  1. Nasal obstruction
  2. Nasal discharge
  3. Recurrent or chronic sinusitis
  4. Loss of smell
  5. Headaches or facial discomfort
  6. Facial swelling especially over the forehead, cheeks and between the eyes
  7. Recurrent asthma attacks
  8. Snoring and obstructive sleep apnea
Treatment

Nasal polyps are usually treated medically first. If this fails to relieve the symptoms or if complications arise, then surgery will be considered.

Medical treatment include:

  1. Nasal steroid sprays
    1. Reduces the inflammation in the lining of the nose, thereby reducing the size of the polyps and relieving the symptoms
  2. Oral Corticosteroids
    1. Very effective in reducing the size of the polyps
    2. However, they contain side effects such as gastric pain, insomnia, palpitations and lethargy
    3. Usually given in high doses for short periods of time
  3. Antibiotics
    1. These are prescribed if there is associated acute or chronic sinusitis
  4. Other medications
    1. Saline douches are often recommended because they rinse the nose clean of infected pus in patients with co-existing chronic sinusitis
    2. Antihistamines are sometimes prescribed if there is a co-existing nasal allergy
Surgery

Surgery may be needed if the nasal polyps do not shrink with medical treatment or if they are associated with serious complications (e.g. cancerous growths).

Surgery is performed through an endoscope through your nose with the help of a navigation system. Performed under general anaesthesia, the procedure will remove the polyps in your nose, thereby opening up the sinus passages again.

Know Your ENT Specialist
Dr Paul Mok
Senior Consultant ENT Surgeon
MBBS, FRCS (Glasgow), FAMS (ORL)

Dr Paul Mok Kan Hwei is a certified specialist in Otolaryngology, Head and Neck Surgery (ENT) and has had a distinguished career in public service for the past 23 years.

He cares for patients with a wide variety of ENT conditions including managing patients with nasal allergies, sinus infections, ear problems and swellings in the head and neck region. His special areas of interests are in Voice, Swallowing and managing patients with Obstructive Sleep Apnea.