nasal polyps

Question 1

what are nasal polyps?

Answer 1

Benign lesions of the nasal mucosa or paranasal sinuses due to chronic
mucosal inflammation

Question 2

what are the risk factors for nasal polyp formation?

Answer 2

• Chronic rhinosinusitis
• Cystic fibrosis (CF)

• Aspirin exacerbated respiratory disease
(AERD; aspirin or NSAID induced):
A triad of asthma, chronic sinusitis with polyps, and bronchospasm

Question 3

what are the clinical features of nasal polyps?

Answer 3

• post nasal drip
• Bilateral nasal obstruction
• Frequently impaired olfactory function (from hyposmia to anosmia)
• Fever and severe facial pain are uncommon.

Question 4

what is post nasal drip?

Answer 4

Abnormally increased nasal mucus secretion that drips down the back of the throat and can lead to coughing, a feeling of obstruction
in the throat, and throat clearing.

Causes include allergies, cold temperatures, viral or bacterial infections, dry air, and certain medications.

First-line treatment includes first-generation antihistamines (e.g., diphenhydramine)

Question 5

what investigations can be done into nasal polyps?

Answer 5

• Nasal cytology for eosinophilia
• Evaluate for associated conditions (e.g., sweat chloride test for CF)
• Nasal endoscopy: bilateral grey polypoid mucosa hypertrophy
• CT: determines the exact location and extent of polyps; also useful to exclude other causes of nasal obstruction

Question 6

how are nasal polyps managed?

Answer 6

Topical or systemic glucocorticoids

Resection of polyps if symptomatic despite medical therapy but recurrence is
common