Nasal polyps

Diagnosis

The diagnosis of the doctor is usually symptoms-based together with assessment of the nose and the whole body. A polyp may be seen by flashing a light into it.

Some tests which may be done to diagnose nasal polyps which include:

• Nasal endoscopy. A nasal endoscope is a tiny tube with a magnifying lens and a lighted camera which is used by the doctor to have a better view of the nasal passages and sinuses.
• Imaging studies.  Computerized Tomography (CT) scan can view the size of the polyp and its location inside the sinuses and as well as assess how swollen and inflamed the polyps are.

The imaging will assist the doctor to check for other blockages in the nasal passages (e.g., unusual structures or other growths which may be benign or malignant)

• Allergy tests. Skin prick test done on the skin of the forearm or upper back may be performed by the doctor to know what your allergies are that cause chronic inflammation. Blood tests may also be done to check for certain antibodies of different allergens.
• Test for cystic fibrosis.  A test for cystic fibrosis called noninvasive sweat test may be recommended by the doctor if your child has been found to have nasal polyps. Cystic fibrosis is a disorder that is passed on by the family (hereditary) which affects the glands that secrete sweat, tears, saliva, mucus, and digestive fluids. Noninvasive sweat test determines if the sweat of a child has an above average salt concentration.
• Blood test. Nasal polyps may be caused by a deficiency of vitamin D levels in the blood.

Treatment

It is quite difficult to eliminate chronic sinusitis with or without polyps. You will have to carefully plan the long-term treatment with your healthcare providers to help ease your symptoms and to treat risk factors such as chronic inflammation and allergies.

Nasal polyp treatment aims to shrink the nasal polyp or fully remove them. The first line of treatment is by using medications. Surgery may be recommended in some cases but it’s not a treatment that lasts because nasal polyps mostly recur.

Medications

The initial treatment for nasal polyps is medication that can reduce the size of the polyps or totally eliminate it. These medications include:

• Nasal corticosteroids. A nasal corticosteroid will be prescribed by the doctor to alleviate symptoms such as irritation and swelling. Furthermore, this treatment can reduce the size of the nasal polyps or totally make them disappear. Budesonide, mometasone, ciclesonide, fluticasone, beclomethasone, and triamcinolone are examples of nasal corticosteroids.
• Corticosteroids. Medication taken orally may be prescribed by the doctor if nasal corticosteroid is not effective such as prednisone administered together with the nasal spray. However, oral corticosteroid has serious side effects, hence they are only taken short-term. In the case that the nasal polyp has become serious, corticosteroid may be administered intravenously.
• Medication for nasal polyps and chronic sinusitis. An intravenous medication such as dupilumab may be administered by the doctor if you have nasal polyps and chronic sinusitis to alleviate nasal congestion and help shrink the nasal polyp.
• Other medications. If you have allergies that promotes swelling in your nasal passages and sinuses for a long time, the doctor may recommend medications such as antihistamines for the allergies and also an antibiotic to resolve the chronic infection or an infection that keeps coming back.

An allergy doctor may also recommend aspirin desensitization treatment which can help treat nasal polyps and sensitivity to aspirin. In this procedure, the doctor slowly adds more dosage of aspirin while the patient is admitted at a clinic or hospital to create a long-term tolerance to aspirin.

Surgery

Endoscopic surgery is an outpatient procedure which uses a tiny tube with a lighted camera (endoscope) to reach for the nasal passages and sinus cavities. A surgical instrument can also be inserted into the endoscope to access the polyps and remove them as well as other blockages in the sinuses.

The surgery does not only remove the nasal polyps, but it also assists in treating sinuses inflammation and prevent further polyp growth as well as widen the pathway from the sinuses down to the nasal passages.

A saline rinse will be prescribed by the surgeon after the surgery to induce healing. Furthermore, a corticosteroid nasal spray is then applied post-surgery in order to avoid the nasal polyps from recurring.