Nasal polyps

Question 1

What are nasal polyps

Answer 1

Growths of the nasal mucosa that can occur in the nasal cavity or sinuses
Often associated with inflammation, particularly in chronic rhinitis
Grow slowly and gradually obstruct the nasal passage

Question 2

Nasal polyps presentation

Answer 2

Usually bilateral (unilateral = red flag for malignancy)
Difficulty breathing through the nose
Snoring
Nasal discharge
Chronic rhinosinusitis
Loss of sense of smell
Symptoms getting progressively worse

Question 3

Nasal polyps associations

Answer 3

Chronic rhinitis or sinusitis
Asthma
Samter’s triad (nasal polyps, asthma, aspirin intolerance/allergy)
Cystic fibrosis
Eosinophilic granulomatosis with polyangitis (Churg-Strauss syndrome)

Question 4

Nasal polyps investigations

Answer 4

Examine nose with speculum and otoscope
Specialist can perform a nasal endoscopy
Appear as round, pale, green/yellow growths on the mucosal wall

Question 5

Nasal polyps differentials

Answer 5

Sinusitis (would have pain)
Foreign body
Tumour
Rhinosinusitis

Question 6

Nasal polyps management

Answer 6

Unilateral polyps - refer to exclude malignancy
Intranasal topical steroid drops or spray (Nasonex/Flonase)
Surgical management if fails:
Intranasal polypectomy - where polyps visible and close to nostrils
Endoscopic nasal polypectomy - where polyps further into nose or in sinuses