Nasal polyps

Definition of polyps

(Pedunculated) protuberances of the mucous membrane are referred to as polyps or tumors. Polyposis is when multiple polyps appear in the same place . In the case of polyposis nasi et sinuum , benign tissue growths grow in the area of ​​the nasal mucosa and the mucous membrane of the paranasal sinuses.

Colloquially, enlarged pharyngeal tonsils (adenoids) in children are incorrectly referred to as “polyps”.

Causes of polyps

Nasal polyps are usually caused by persistent inflammation of the nasal mucosa or paranasal sinus mucosa. As a result, an edematous swelling forms, which descends into the main nasal cavity and appears as a polyp. The following diseases are associated with the growth of nasal polyps:

• Allergy sufferers and asthmatics often suffer from an allergic cold (allergic rhinitis). The frequent inflammation of the nasal mucous membranes promotes the formation of polyps.
• People with chronic sinusitis also tend to develop polyposis nasi et sinuum.
• Patients with an intolerance to painkillers (analgesic intolerance) are sometimes affected by nasal polyps. As soon as asthma is present in addition to nasal polyps and intolerance to painkillers, experts speak of the so-called Samter triad (aspirin triad) .
• Cystic fibrosis patients often suffer from nasal polyps. The metabolic disease leads to viscous mucus that drains poorly and subsequently leads to the formation of nasal polyps. If nasal polyps occur in children , the presence of cystic fibrosis is likely and a medical evaluation should take place.
• The hereditary disease primary ciliary dyskinesia leads to functional restrictions of the cilia of the nasal mucosa. Normally, the cilia transport small particles and pathogens to the outside. If this is disturbed in the context of primary ciliary dyskinesia, recurring inflammation of the mucous membranes can occur, leading to polyposis nasi et sinuum.
• In addition, the cause of polyp formation can be related to anatomical peculiarities . If, for example, the nasal septum is crooked (septum deviation) or the sinus openings (ostia) are too narrow, the nasal secretion cannot drain off in the event of recurring inflammation.

A number of risk factors are also known that favor the development of nasal polyps. Which includes:

• Breathing air that is dry or contaminated with chemicals
• Frequent alcohol consumption after surgical removal of the nasal polyps
• Weak immune system

Symptoms of nasal polyps

At first, those affected hardly notice any symptoms. As soon as the nasal polyps have reached a certain size, it can lead to obstructed nasal breathing and limited smelling ability . As a result, the affected patients often breathe through their mouths, which means that the air is no longer sufficiently cleaned, humidified and heated. At night, the affected patients often notice snoring and sleep disorders , which can lead to headaches, difficulty concentrating and tiredness the next morning. A stuffy nose can also make your voice nasal .

Polyps themselves, being benign mucosal growths, are not painful. However, if the exits from the paranasal sinuses (ostia) become blocked, painful inflammation of the paranasal sinuses (sinusitis) can occur. In the presence of sinusitis, headaches and a purulent runny nose can also occur.

In most cases, nasal polyps are bilateral. If the symptoms are only on one side, the presence of a tumor should be checked.

Complications of nasal polyps

Complications arise when the mucosal proliferations obstruct the nasal airways as they grow. If the patients breathe mainly through the mouth, the air can no longer be warmed up and humidified sufficiently and pathogens are absorbed more easily. Inflammation of the throat (pharyngitis), larynx (laryngitis) and bronchi (bronchitis) occur frequently.

In addition, the paranasal sinuses are no longer adequately ventilated, and the accumulating secretion can no longer drain off. This can lead to serious inflammation of the paranasal sinuses (sinusitis), which can lead to orbital cellulitis, meningitis (meningitis) and encephalitis (encephalitis).

Diagnosis of nasal polyps

You can first contact your general practitioner with your complaints. If necessary, they can refer you to a specialist (ear, nose and throat doctor) .

In order to make the correct diagnosis, the doctor treating you will ask you a few questions about your symptoms during the anamnesis interview .

This will be followed by a physical examination and a nose reflection (rhinoscopy) . The polyps appear as glassy, ​​honey-colored to pink, droplet-like mucosal growths that can grow from several millimeters to centimeters in size.

In addition, imaging procedures such as a computed tomography (CT) examination or an X-ray may be necessary to determine the extent of the polyps or to be able to plan an operation.

If there is a suspicion that an allergic disease is the cause of the nasal polyps, a skin prick test can be carried out. In this allergy test, tiny amounts of an allergy-causing substance (allergen) are injected into the skin.

You can do this yourself for nasal polyps

As a rule, nasal polyps should be treated with appropriate therapy. To support healing or to prevent the formation of polyps, you can observe the following tips:

• Make sure that the air in the room is humid , if necessary by using room air humidifiers.
• Avoid alcohol and cigarettes .
• Make sure you lead a healthy lifestyle with a balanced diet, drinking enough water and regular physical activity.
• If you work with pollutants at your workplace that promote the formation of polyps, you should talk to your employer . A change of job and better work clothes should be considered in this case.

Therapy of nasal polyps

Therapy of nasal polyps consists of a drug and surgical approach. Depending on the extent and symptoms, different treatment approaches are possible.

Corticoid nasal sprays have an anti-inflammatory effect and inhibit the growth of nasal polyps. Glucocorticoids should be used over a very long period of up to six months.

Herbal secretolytics help loosen the stuck mucus.

Antibiotics are only used if there is a bacterial infection with a purulent runny nose.

If the polyps can be traced back to an allergic reaction, the triggering substances (allergens) should be avoided. Alternatively, specific immunotherapy (hyposensitization) can help.

In patients with an aspirin intolerance, an attempt can be made to achieve freedom from symptoms by adaptively increasing the aspirin dose.

If there is no improvement despite drug therapy, or if the patient is severely restricted by obstructed nasal breathing, surgical therapy can be considered. An ENT doctor removes the pesky polyps in what is known as a polypectomy . Depending on the size of the polyps, the operation can be performed in a doctor’s office under local anesthetic or as part of a hospital stay in a minimally invasive operation. As a rule, nasal spray containing corticosteroids must continue to be used after a successful operation in order to achieve long-term therapeutic success.

Even after successful therapy, nasal polyps can always come back. In this case, experts speak of so-called recurrences .

When to seek help

Medical advice should always be sought when nasal polyps occur. Even if the polyps don’t cause any problems at first, they can cause breathing problems and serious complications later on. Children should always see a pediatrician to rule out the possibility of the metabolic disease cystic fibrosis. Nasal polyps can be very similar to a sometimes malignant tumor disease, which is why it should be clarified at an early stage.

If breathing difficulties or fever and chills occur, a doctor’s practice or a hospital should be consulted immediately .

How can Med-Healths help?

With the Med-Healths App you can contact a doctor and talk to him in detail about your symptoms. They can help you classify your symptoms and make the right diagnosis. They can also prescribe medications to help treat nasal polyps. In the case of a serious illness or other aspects, he can refer you to a suitable specialist.