Nasal polyps

Question 1

Definition

Answer 1

• Nasal polyps are round, soft, pale, pedunculated
outgrowths arising from the nasal or sinus mucosa.
• They are basically prolapsed, congested,
oedematous mucosa, described by some as ‘bags
of water’.
• Usually arise from the middle meatus and
turbinates

Question 2

Symptoms

Answer 2

• Nasal obstruction, watery discharge, postnasal
drip and loss of smell.
• They occur in patients with all types of rhinitis, but
especially in allergic rhinitis

Question 3

Facts

Answer 3

• Nasal polyps may be associated with asthma and
aspirin sensitivity.
• Cystic fibrosis should be considered in any child
with nasal polyps.
• A polyp that does not have the typical smooth pale
appearance may be malignant.
• A unilateral ‘polyp’ may be a neoplasm.
• If there is a purulent discharge, swab and give
antibiotics

Question 4

Treatment

Answer 4

The initial treatment should be medical.
• A medical ‘polypectomy’ can be achieved with oral
prednisolone 50 mg daily for 7 days.
• Supplement this with a corticosteroid spray such
as betamethasone, starting simultaneously and
continuing for at least 3/12
• Give antibiotics for any purulent nasal discharge

Simple polyps can be readily snared and removed,
but referral for surgical intervention since the aim
is to remove the polyp with the mucosa of the
sinuses (often ethmoidal cells). This reduces the
incidence of recurrence.