Nasal polyps are teardrop-shaped, noncancerous growths on the lining of your nasal passages or sinuses. Small nasal polyps may cause no problems and go unnoticed. Larger nasal polyps can block your nasal passages or sinuses and cause breathing difficulties, a loss of your sense of smell, frequent sinus infections and other problems.
Although nasal polyps can affect anyone, they're more common in adults, particularly those with asthma, frequent sinus infections and allergies. Children with cystic fibrosis often develop nasal polyps.
Medications can often lessen the size of nasal polyps or eliminate them, but surgery is sometimes necessary to remove them. Even after successful treatments, nasal polyps often return. Nasal polyps are soft, noncancerous growths on the lining of your nose or sinuses. They often occur in groups, like grapes on a stem.
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Scientists don't yet fully understand what causes nasal polyps. It's not clear why some people develop chronic inflammation or why ongoing inflammation triggers polyp formation in some people and not in others. The inflammation occurs in the fluid-producing lining (mucous membrane) of your nose and sinuses. There's some evidence that people who develop polyps have a different immune system response and different chemical markers in their mucous membranes than do those who don't develop polyps.
Nasal polyps can form at any age, but they're most common in young and middle-aged adults. Nasal polyps may form anywhere in your sinuses or nasal passages, but they appear most often in an area where sinuses near your eyes, nose and cheekbones all drain through winding passages into your nose (ostiomeatal complex).
Nasal polyps are associated with chronic inflammation of the lining of your nasal passages and sinuses (chronic sinusitis). If you have several polyps or large polyps, they may obstruct your nasal passages and sinuses. As a result of these conditions in your nose and sinuses,
you may experience some of the following signs and symptoms : -
A runny nose
Decreased or no sense of smell
Loss of sense of taste
Facial pain or headache
Itching around your eyes
You may have small nasal polyps and experience no signs or symptoms.
When to see a doctor :
Signs and symptoms of nasal polyps are similar to many other conditions, including the common cold. If your condition continues for more than 10 days, see your doctor.
If you have signs or symptoms of nasal polyps, you're likely to start by seeing your primary care physician. However, your doctor may refer you to an ear, nose and throat (ENT) specialist or an allergy specialist (allergist) for diagnostic tests or treatment.
Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to prepare ahead of time. Here are some suggestions to help you get ready for your appointment and understand what to expect from your doctor.
What you can do
Be aware of any pre-appointment restrictions. When you make your appointment, ask if you need to fast for blood work or if you need to do anything else to prepare for diagnostic tests.
Write down all of your symptoms, even if they seem unrelated to your nose or sinuses. Your doctor will want to know details about when your symptoms started and whether anything seems to make them better or worse.
Take along a family member or friend, if possible. Having someone along can help you recall all the information provided during your appointment.
Make a list of your other medical conditions. Your doctor will want to know if you're currently being treated for allergies, asthma or any other health conditions.
Make a list of all your medications, including over-the-counter drugs and vitamins or supplements.
Questions to ask your doctor
Because time with your doctor is limited, writing down a list of questions will help you make the most of your appointment. List questions for your doctor from most important to least important in case time runs out. If you think you have symptoms of nasal polyps, you may want to ask some of the following questions:
What is likely causing my problems with breathing, sense of smell and other problems related to my nose?
What kinds of tests do I need?
What is the best course of action?
Do I need to see a specialist? What will that cost? Will my insurance cover it?
What type of follow-up examinations or care will I need?
If I have nasal polyps, can we effectively treat the underlying cause of inflammation?
What should I expect to happen over the long term?
Will my new symptoms affect how I manage my other health conditions?
Do I need to follow any restrictions?
Is there a generic alternative to the medicine you're prescribing?
Are there any brochures or other printed material that I can take home with me? What websites do you recommend?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to respond may free up time to go over any points you want to spend more time on. Your doctor may ask:
When did you begin experiencing symptoms?
When did you last have a cold or sinus infection?
How often do you have colds or sinus infections?
Do you have allergies? Do you know what you're allergic to?
Do you have asthma? How well are you able to manage it?
Do you often take aspirin, Advil, Aleve or any other over-the-counter drugs for pain?
Do you smoke, or are you exposed to secondhand tobacco smoke?
In your work or hobbies, are you exposed to chemical fumes or other airborne pollutants such as dust or debris from a leaf blower?
Have you ever had any sinus or nasal surgery?
Stop smoking and get your weight down if you are overweight. (See Healthy Living). If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first couple of days after the operation. Sort out any tablets, medicines, inhalers that you are using. Keep them in their original boxes and packets. Bring them to the hospital with you. On the ward, you may be checked for past illnesses and may have special tests to make sure that you are well prepared and that you can have the operation as safely as possible. Please tell the doctors and nurses of any allergies to tablets, medicines or dressings. You will have the operation explained to you and will be asked to fill in an operation consent form. Many hospitals now run special preadmission clinics, where you visit for an hour or two, a few weeks or so before the operation for these checks. If you have a cold in the week before your admission to hospital, please telephone the ward and let the ward sister know. The operation will usually put off, and you will be given time to get better before being sent for again. You will need to get over the cold before the operation can be done because by having an anaesthetic the cold could turn into a serious infection in the chest.
You may be given oxygen from a face mask for a few hours if you have had any chest problems in the past. There is usually some pain and discomfort around the nose after this operation. With packing inside your nose, you will have to breathe through your mouth. This will make your mouth feel dry. Take frequent drinks to keep it moist. You may find that the nasal packing will make your eyes water or give you a headache. Ask for painkillers if the pain is not well controlled or if it gets worse. A general anaesthetic may make you slow, clumsy and forgetful for about 24 hours. The nurses will help you with everything you need until you are able to do things for yourself. Do not make important decisions during this time. The next day, when the nurses take the packing from your nose, there will be a little bleeding. This usually stops very quickly. Splints are usually left in place for about two weeks. You will probably be able to go home later the same day. The nurses will check that your nose is comfortable and is not bleeding. You will be given some cream to use inside your nose, together with some nose drops and advice about steam inhalations. Before you leave the ward, you will be given an appointment to attend the ENT (ear, nose, and throat) outpatient clinic for a check-up by the surgeon. The results of the examination of the polyp(s) will be ready by then. The nurses will advise you about sick notes, certificates etc.
Take two painkilling tablets every six hours to control any pain or discomfort in your nose. The nose will feel blocked for 7 to 10 days after your operation, but will gradually improve. Do not blow your nose until two days after you get home, and then start off by blowing it VERY GENTLY. To begin with, you will see blood staining in your handkerchief. Most of this will be old blood from your operation, but there may be a little fresh bleeding as well. If possible, try to avoid catching a cold during your first week at home. If you do get a cold you should see your general practitioner for some antibiotics. Take it easy at home. Do not do anything too energetic during the first few days in case this makes your nose bleed. If you usually do hard physical exercise such as weight training, jogging, keep fit classes, etc. you will be fit enough to return to these activities about two to three weeks after your operation. Any earlier, and there is a risk that you will make your nose bleed. Avoid smoky atmospheres such as pubs and clubs, because cigarette smoke will irritate the inside of the nose. Do not forget to use the cream, steam inhalations and nasal drops. You will be fit to drive as soon as you leave the hospital. You should be able to go back to work one week after your operation. Avoid swimming and diving until you have seen the surgeon in the clinic.