Nasal polyposis is the most common form of chronic rhinosinusitis caused by the formation of polyps in the mucous membranes and nasal cavity. According to the World Allergy Organization (WAO), nasal polyposis affects about 1% to 4% of the population. The onset of the disease is usually before the age of 30, but diagnosis is often considerably delayed.
Nasal Polyp. Image Courtesy of MathieuMD
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Causes of nasal polyposis
Table of Contents
Nasal polyposis is caused by the formation of polyps in the nasal passages and nasal mucosa. Polyps are soft, nonpainful, noncancerous growths that can be invasive. They are the result of chronic inflammation, the cause of which is unknown in 80% of cases. Nasal polyposis is sometimes associated with asthma, allergy, drug sensitivity (e.g. aspirin intolerance), or immune disorders. Rare diseases such as cystic fibrosis or Churg-Strauss syndrome (inflammation of the blood vessels) may also cause polyps.
Symptoms of nasal polyposis
Small polyps are asymptomatic, but larger polyps can block the nasal cavity and obstruct breathing. They also contribute to respiratory infections.
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Polyposis symptoms are as follow:
- Runny nose (cold)
- Nasal congestion (breathing difficulties)
- Postnasal drip
- Headaches
- Facial pain in the forehead, eyes, or teeth
- Loss of taste and smell (anosmia)
- Snoring
- Sleep apnea
- Asthma attacks (in asthmatic persons)
- Recurrent/chronic sinusitis
Nasal polyposis also has psychological consequences: Many of those suffering from anosmia say they have lost the desire to eat and have felt depressed, according to a study. Notably, a large number of patients with nasal polyposis also have atopic dermatitis.
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Treatment of nasal polyposis
Nasal polyposis is a difficult disease to treat permanently. Most patients resort to “natural” methods, such as saline sprays or essential oils, but the improvement of symptoms is partial and temporary. Nasal polyposis can also be treated with nasal or oral corticosteroids, but only for a limited period of time to avoid the side effects of overuse. Antihistamines or antibiotics may be prescribed on a case-by-case basis.
Between 46% and 78% of patients require one or more surgical procedures, but polyps very often return after surgery. Surgery involves inserting a small tube (endoscope) into the nostril, removing the polyps, and opening the nostrils to facilitate the passage of air.
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To reduce the risk of recurrence, it is advisable to maintain good nasal hygiene (regular washing with physiological saline solution), avoid airway irritants (allergens, tobacco, dust, etc.), humidify the air in the house, and, if necessary, treat asthma well.
References
The Association Between Olfaction and Depression: A Systematic Review
https://www.mayoclinic.org/diseases-conditions/nasal-polyps/symptoms-causes/syc-20351888
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