nasal polyps

Nasal polyps: description

Nasal polyps are soft, benign growths of the nasal mucosa that protrude into the nasal cavities. They sprout from the mucous membrane with which they are connected via a kind of stem. Some are only a few millimeters in size and do not disturb, others can grow into large structures that displace the nasal spaces. Since this restricts the nasal breathing, the disease can be very annoying and severely limit the quality of life.

How is the nose built?

The nose consists of left and right main nasal cavities separated by the nasal septum. The main caves are followed by two paranasal sinuses (sinuses), which are connected via excretory ducts to the respective main nasal cavity. Major and minor cavities are lined with a mucous membrane that, among other things, moistens and filters the respiratory air.

Who is particularly affected by nasal polyps?

Nasal polyps are widespread. How they arise is still unclear. So far, it is known that there are some diseases in which sufferers more often develop polyps in the nose – for example, patients with bronchial asthma. Of these, up to 40 percent also suffer from nasal polyps. About 25 percent of patients with nasal polyps are allergic to acetylsalicylic acid (ASA).

Nasal polyps: symptoms

Patients with nasal polyps are usually impaired by limited nasal breathing. They do not get enough air through the nose and therefore breathe more often through the mouth. Sufferers often snore because of this, suffer from sleep disorders and their performance is limited. In addition, the air breathed through the mouth is not filtered.

Sufferers feel that they have a stuffy nose all the time, which can also lead to a nasal voice. With colds, the mucus often runs down their throats. In addition, patients suffer from recurrent inflammation of the sinuses (sinusitis) and dull headaches. In addition, their ability to smell can be limited and thus also the sense of taste – a severe loss of quality of life. Nasal polyps in children can cause otitis media.

Nasal polyps: causes and risk factors

Polyps in the nose are growths that emanate from a persistently inflamed nasal mucosa. Under the microscope you can see fluid retention and endogenous inflammatory cells. The exact mechanism is still unknown. A nasal polyp usually grows out of one of the paranasal sinuses into the main nasal cavity. Mainly the nasal polyps develop in the maxillary sinus (maxillary sinus) or the ethmoidal cells (cellulae ethmoidales). They come out of the excretory ducts and lie mostly in the middle nasal passage under the middle turbinate.

Common cause of the formation of nasal polyps is a tendency of the mucous membrane to inflammation (disposition). Risk factors for the development of polyps in the nose are:

• Allergy to painkillers
• asthma
• bronchitis
• Kartagener syndrome (rare hereditary disease with the symptoms nasal polyp, mirror-image arrangement of the organs, dilatation of the bronchi)
• Cystic fibrosis (also cystic fibrosis)

Nasal polyps: examinations and diagnosis

In order to diagnose nasal polyps, your doctor first asks you in detail about your medical history (anamnesis). For this he asks you the following questions:

• Do you get good air through your nose?
• Are you more likely to suffer from sinusitis?
• Do you often run the nose?
• Do you suffer from asthma or bronchitis?

In the examination, the doctor first reflects the nose. He introduces a small funnel-shaped forceps into a nostril and illuminates with his headlamp. He assesses the appearance of the nasal mucosa and can detect if polyps are in the nasal cavity. In addition, the posterior nose can be examined by inserting a mirror into the mouth and pointing it upwards into the throat.

A further investigation is the so-called endoscopy. The doctor introduces a small tube with a camera into his nose. So he can examine the excretory ducts of the paranasal sinuses and detect any polyps. In addition, computed tomography (CT) can be used to determine the exact size of the polyps. This allows the surgeon to better plan a possible surgery later.

Which diseases are still in question?

Most nasal polyps occur on both sides. If they are only present on one side, a tissue sample is usually taken under local anesthesia and examined in the laboratory. It is determined whether it is polyps or another type of proliferation. Basically, a doctor must distinguish nasal polyps from other possible diseases. These include:

• Meningoencephalocele (brain tissue incident, often congenital)
• Juvenile nasopharyngeal (nasopharyngeal tumor, mainly in male adolescents)
• Papilloma or squamous cell carcinoma of the nose (other tumors of the nose)
• Aspergilloma (mold infestation)

Nasal polyps: treatment

Depending on how severe the symptoms of the nasal polyps are, either a conservative (drug) therapy or an operative treatment of nasal polyps is preferred.

Treatment with drugs

If the nasal mucosa is only slightly swollen, an attempt can be made to reduce it by using cortisone-containing nasal sprays. Cortisone inhibits the activity of inflammatory cells and thus relieves the inflammatory reactions, which include the swelling of the nasal mucosa. It is important to apply the nasal spray regularly and for several months. Patience is required: However, the symptoms often only improve after a few weeks of use. Nasal sprays or drops are preferred to cortisone in tablet form because they are effective only in the nose and thus can not cause side effects in other organs.

OP as a therapy option

Many patients have their nasal polyps removed, which immediately improves nasal breathing significantly. In addition to the removal of the polyps, the surgeon also extends the sinus ducts. So they should be better ventilated and less easily ignited.

What you can do yourself

If you suffer from polyps in the nose, you should pay attention to a regular nose care. These include inhalations and saltwater nasal douches. So the mucous membrane of the nose is moistened, possible pathogens such as bacteria can be flushed out and the risk of developing sinusitis decreases. In alternative medicine, nasal polyps also use homeopathy. Let an ENT specialist advise you on the means by which you can support your nasal mucosa.

Nasal polyps: disease course and prognosis

As nasal polyps grow slowly, patients often get used to the symptoms and seek medical attention late. With the right therapy, the symptoms can be alleviated. An operative removal of the nasal polyps often improves the symptoms quickly. Nevertheless, in about 75 percent of patients, nasal polyps grow again in the first years after removal. Therefore, it is advisable to use long-lasting cortisone nasal sprays even after nasal polyp surgery. These can prevent new polyps from appearing in the nose. In the course of a computer tomography can be determined whether the drug therapy actually works. Lies the nasal polyps underlying another condition, this should be treated.