Main
- Surgical removal of polyps is discussed in cases of pronounced nasal breathing impairment or frequent complications, when other measures do not help.
- Bilateral nasal congestion persists for weeks, and ordinary nasal remedies help little or not at all.
- Examination with an endoscope shows the appearance, size and location of the polyps, while computed tomography of the sinuses shows the extent of the process.
- An allergist-immunologist is involved in cases of concomitant allergic reactions that maintain inflammation in the nasal mucosa.
- Humidifying the air indoors reduces drying out of the mucosa, especially during the heating season and when using an air conditioner.
What is nasal polyposis
Nasal polyposis is the growth of soft benign formations on the mucous membrane of the nose and paranasal sinuses. Such formations make nasal breathing difficult, reduce the sense of smell and contribute to frequent inflammation.
What happens in the body
The mucous membrane of the nose and paranasal sinuses is constantly in contact with air, dust and microbes, so it is the first to react to irritation. With prolonged inflammation or allergy, the cells of the mucous membrane begin to retain fluid and swell, forming soft outgrowths. These outgrowths gradually enlarge and fill the lumen of the nasal passages, hindering the free passage of air. A person notices that breathing through the nose becomes more difficult, and familiar smells are felt more weakly. The stagnation of air and mucus creates a favourable environment for repeated inflammation, which supports the growth of the formations. Over time, breathing through the nose may become so difficult that one has to breathe through the mouth, especially during sleep. If nasal breathing is persistently impaired, it is reasonable to discuss this with a doctor rather than wait for the condition to worsen.
What causes it to develop
- Chronic inflammation of the nasal and sinus mucosa: constant irritation maintains tissue swelling and creates conditions for the growth of outgrowths.
- Allergic rhinitis and other allergic diseases: a reaction to allergens causes persistent swelling, which over time becomes fixed in the form of formations.
- Hereditary predisposition: close relatives more often have a similar condition, which points to the role of innate characteristics of the body.
- Unfavourable environmental factors: polluted air, dust and strong odours irritate the mucous membrane and intensify its reaction to external influences.
- Disorders of the immune system: failures in the body's defence reactions change the response of the mucous membrane to irritants and maintain prolonged inflammation.
Who encounters this more often
Nasal polyposis is more often detected in adults, especially in middle age, whereas in children it occurs noticeably less often. In people with prolonged allergic rhinitis or chronic sinus inflammation, the formations are found far more often than in others. Heredity also plays a role: if close relatives have had a similar condition, the risk increases. Residents of cities with polluted air and workers in dusty industries encounter this more often because of constant irritation of the mucous membrane. Disorders of the immune system add to this list people with an altered defence reaction of the body. It has been noted that in men the formations are detected somewhat more often than in women, although the exact reasons for this difference have not been established. With persistent nasal congestion and a weakening sense of smell, it is worth having an examination by a specialist to clarify the cause of the condition.
What symptoms can there be?
Nasal polyposis develops gradually and often resembles a lingering cold. A person attributes the congestion to a cold or fatigue for a long time, until breathing becomes noticeably difficult.
How it is noticed at the very beginning
Nasal polyposis begins with a feeling that the cold does not go away after usual treatment. The congestion persists for weeks, although there are no longer any signs of a cold. At night, breathing becomes more difficult, so the person wakes up with a dry mouth. The sense of smell weakens imperceptibly: first, subtle odours are lost, then food seems almost tasteless. Mucous discharge appears from the nose, sometimes with an admixture of pus. Gradually, pressure in the facial area or a headache is added, and snoring disturbs the sleep of both the person and their loved ones. If such signs persist for a long time, it is worth seeing an ENT doctor to find out the cause.
Signs that occur most often
- Nasal congestion: does not go away after usual treatment of a cold, so the person breathes with difficulty for months and gets used to this state.
- Difficulty with nasal breathing: especially noticeable when lying down, when mucus stagnates and the passage narrows even more.
- Reduced sense of smell: odours first become dull, and then may disappear completely, and this changes the taste of food.
- Nasal discharge: may be mucous or purulent, requires attention if it persists for a long time and recurs.
- Pressure in the facial area: felt as heaviness at the bridge of the nose or cheekbones, sometimes turns into a headache by the evening.
- Snoring and sleep disturbance: breathing at night becomes noisy and intermittent, so the person does not get enough sleep.
When to seek urgent help
Examinations and tests
Examination for nasal polyposis helps the doctor see the picture of the mucosa and understand whether there is an allergic background. Below are the methods used in practice and what information each of them provides.
How the examination begins
The examination begins with an inspection of the nasal cavity, which the ENT doctor performs using an endoscope. The endoscope allows looking into the deep parts of the nose and assessing the appearance of the polyps, their size and location. During the examination, the doctor pays attention to the colour of the mucosa, the presence of discharge and the condition of the nasal passages. If the picture is incomplete, a computed tomography of the paranasal sinuses is prescribed to see how deeply the process extends. Allergy tests or a blood test for allergens help identify the link between polyps and a reaction to household, food or pollen irritants. Assessment of olfactory function shows how much the perception of smells has been affected, which is important for the overall picture. If another formation is suspected, a biopsy is performed, and its result clarifies the nature of the growths. Keep all examination results so that at a follow-up appointment the doctor sees the dynamics rather than starting from scratch.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: take all previous ENT doctor's conclusions so that the specialist sees how the condition developed and which methods have already been used.
- Images and discs: bring the results of computed tomography of the sinuses, if they were performed, because they show the spread of the process over time.
- Allergy test results: prepare the data of tests or a blood test for allergens so that the doctor assesses the possible link between polyps and a reaction to irritants.
- Notes about smell: note when and how the perception of smells changed, because this information helps assess olfactory function at the appointment.
- List of questions: write down in advance what you want to clarify with the doctor so as not to forget anything important during the conversation and examination.
Which doctor should I see?
When nasal polyposis is suspected, the first doctor is usually an otorhinolaryngologist, and if the condition has an allergic nature, an allergist-immunologist joins the follow-up. Below we explain who manages this condition, what components make up the care, and what depends on the patient themselves.
Which specialist manages this condition
Nasal polyposis is managed by an ENT doctor, who examines the nasal cavity and assesses how much the growths interfere with breathing. If there is no specialist nearby, start with a physician or a general practitioner: they will listen to the complaints and refer you to the right doctor. An allergist-immunologist joins in when the person has concomitant allergic reactions, as these often maintain inflammation in the mucosa. At the first appointment, the ENT doctor asks about the duration of symptoms, past infections and reactions to smells, and then examines the nasal passages. The doctor clarifies how the person breathes during the day and at night, whether there is snoring, headache and a decrease in the sense of smell. The allergist-immunologist, in turn, finds out what exactly the body reacts to and how this is connected with exacerbations. Such a joint approach helps to understand the cause of the condition and choose the appropriate direction of care.
What treatment consists of
- Follow-up with an ENT doctor: regular examinations allow seeing how the condition of the nasal cavity changes and noticing deterioration in time.
- Selection of therapy by the doctor: the specialist takes into account the severity of symptoms and the cause of the disease, choosing anti-allergic or anti-inflammatory agents.
- Nasal irrigation with saline solutions: this procedure is performed as recommended by the doctor; it helps to moisturise the mucosa and reduce irritation.
- Surgical intervention: surgery is discussed in case of pronounced breathing impairment or frequent complications, when other measures do not give the desired effect.
- Treatment of concomitant allergic diseases: addressing the allergy reduces the load on the mucosa and decreases the frequency of exacerbations in the future.
What depends on the patient themselves
The regularity of follow-up with an ENT doctor largely determines how predictable the course of nasal polyposis will be. If the person comes for examinations at the appointed times, the doctor notices changes earlier and manages to adjust the care. Missed visits lead to the fact that worsening of breathing and the return of symptoms are detected already at an advanced stage. Following the recommendations for nasal irrigation and taking the prescribed agents keeps the mucosa in a calmer state. Refusal to consult an allergist-immunologist when there is an obvious allergy leaves the cause of inflammation unattended. Keeping a diary where exacerbations and their connection with the season or contacts are noted gives the doctor useful information. An honest account of what prevents following the advice helps to choose a realistic plan rather than a formal one. Stopping follow-up on one's own usually returns the person to the original complaints.
What helps prevent an exacerbation?
There is no specific prevention of nasal polyposis, but the risk of exacerbations can be reduced by controlling allergies and promptly treating inflammatory diseases of the nose and sinuses. Below is what depends on the person themselves: daily habits, regular monitoring and attention to one's own condition.
What to change in habits
Humidifying the air indoors is one of the habits that directly affects the condition of the nasal mucosa. Dry air dries out the mucosa, it loses its protective properties and reacts more acutely to irritants. Avoiding contact with irritants and polluted air reduces the load on the nose and sinuses, especially during the flowering season or when working with dust. Prompt treatment of a runny nose and sinusitis prevents the inflammation from dragging on and becoming chronic. Controlling allergic reactions and being monitored by an allergist help keep under control the triggers that provoke exacerbations. In chronic nasal problems, regular examinations by an ENT doctor allow changes to be noticed before they become noticeable. Giving up the habit of breathing through the mouth in dry and cold air reduces irritation of the mucosa. If exacerbations recur, it is worth discussing with the doctor which of the habits give the greatest effect in your particular case.
What should be kept under control
- Allergy control: being monitored by an allergist helps identify triggers and reduce the frequency of reactions that maintain inflammation in the nose.
- Prompt treatment of a runny nose and sinusitis: prolonged inflammation maintains swelling of the mucosa, so it is important not to leave it unattended.
- Indoor air humidity: humidification reduces drying out of the mucosa, especially during the heating season and when the air conditioner is running.
- Contacts with irritants: dust, strong odours and polluted air intensify the reaction of the nose, so they are excluded where possible.
- Regular examinations by an ENT doctor: in chronic nasal problems they help to notice changes in time and adjust monitoring.
How often to see a doctor
Regular monitoring by an ENT doctor is needed even when you feel well, because changes in the nose and sinuses are not always felt immediately. In chronic nasal problems, examinations help to notice how the condition reacts to the change of season, contact with allergens and past colds. The allergist, in turn, monitors reactions to triggers and helps keep them under control. If a runny nose or congestion lasts longer than usual, the visit should not be postponed until a routine examination. Between visits it is useful to note what preceded the worsening: flowering, dry air, a cold or contact with dust. Such notes make the conversation with the doctor specific and help to build monitoring more precisely. A routine examination is a way to notice in time what does not yet bother you and not to let the condition reach an exacerbation.
What is worth remembering
Nasal polyposis is a condition in which growths appear on the mucous membrane of the nasal passages and sinuses. Below are the main conclusions that help you understand how to behave with this condition.
Main conclusions
Nasal polyposis does not always manifest itself in the same way: for one person it is merely difficulty breathing, for another it is loss of smell and constant congestion. The growths form gradually, so changes in how you feel are easily put down to a cold or fatigue. A characteristic feature of nasal polyposis is that breathing through the nose is affected on both sides, and ordinary nasal remedies help little or not at all. Over time, headache, snoring and reduced ability to work due to lack of air are added to this. Nasal polyposis is often combined with intolerance to certain smells and with a reaction to dust, which noticeably worsens the quality of life. You should not put off a visit to the doctor: the longer you delay, the harder it is to restore free breathing. In making a decision, you should rely on an in-person examination by a specialist, and not on the advice of acquaintances or random publications.
