Nasal polyps are pathological changes in the mucous membranes of the sinuses. If treated early, control is usually successful.
What are nasal polyps?
Schematic diagram showing the anatomy of the nose in nasal polyps. Click to enlarge. Nasal polyps are benign growths or growths of the mucosa that protrude into the nasal cavity from the sinuses (especially the maxillary and ethmoid sinuses). These growths are usually protrusions of the mucosa of the paranasal sinuses. If nasal polyps are not treated in time, they can result in various secondary diseases. The term ‘polyp’ comes from the Greek language and translates as ‘many-footed creature’. This descriptive name goes back to the appearance of polyps in so-called cnidarians (multicellular aquatic animals). As a rule, nasal polyps occur mainly in adults. Children are rarely affected. According to estimates, nasal polyps occur in up to twelve percent of the German population; men are affected by nasal polyps approximately twice as often as women.
Causes
Nasal polyps are usually caused by inflammation or fluid retention in the mucous membrane of the paranasal sinuses. Corresponding sinusitis is also known as sinusitis. Nasal polyps can also develop due to further irritation of the mucous membrane of the paranasal sinuses. For example, as a result of chronic rhinitis. And a fungal infestation of the paranasal sinuses can also promote the development of nasal polyps. Furthermore, various allergies that lead to irritation of the nasal mucosa can also cause nasal polyps; it has also been scientifically described that nasal polyps occur more frequently in people who are intolerant to certain painkillers. Irritation of the mucous membranes, which can promote nasal polyps, is also partly caused by pollutants in the air we breathe. Hereditary factors can also play a role in the development of nasal polyps: For example, people who have a family history of nasal polyps generally carry a higher risk of developing nasal polyps.
Symptoms, complaints and signs
Nasal polyps can persist for a long period of time without noticeable symptoms. Depending on their size, number and location, the growths can interfere with nasal breathing. Then the typical nasally voice sets in. Those affected describe the voice as nasal, muffled and distorted, and with large polyps there are problems pronouncing certain words. Snoring occurs at night and is accompanied by sleep disturbances, and headaches and increased sniffling occur during the day. Performance is reduced as a result of fatigue. The polyps increase the risk of middle ear infections as well as inflammation of the paranasal sinuses. Smelling ability is usually greatly reduced or completely lost. If the nasal polyps continue to grow in size, the nose may thicken. In addition, the distance between the eyes sometimes increases, resulting in what is known as hypertelorism. If the growths are treated, however, such complications do not occur. The symptoms disappear completely and those affected can breathe freely again after treatment is completed. Externally, nasal polyps are usually not recognizable. At most, the blocked nose and irritated airways and tear ducts indicate a serious condition that needs to be investigated.
Course
The course of nasal polyp disease depends, among other things, on the factors underlying the nasal polyps, the stage of development of the nasal polyps, and also the previous duration of nasal polyp disease. Basically, it can be said that an early start of treatment of nasal polyps usually also leads to a more favorable course of the disease. However, there is also a risk that polyps will form again after successful treatment of nasal polyps. According to experts, such a residual risk exists especially after surgical removal of nasal polyps. If treatment is started early, there is usually a good prognosis that accompanying symptoms of nasal polyps, such as restricted nasal breathing or headaches, will recede. Untreated nasal polyps can lead to secondary diseases: If the nose is not sufficiently ventilated, this can lead to ear complaints, among other things.Sufferers also breathe more through the mouth, which can promote throat infections.
Complications
As a rule, nasal polyps have a very negative effect on the patient’s quality of life. In this case, most of those affected suffer from a permanently blocked nose, which also cannot be easily freed. Permanent snoring can also occur due to the nasal polyps, possibly having a very negative effect on the relationship with the partner. Similarly, the nasal polyps favored certain inflammations and infections, so that patients may become ill more often. Headaches and inflammation in the ears may also occur due to the condition. Furthermore, the nasal polyps can also lead to psychological discomfort or depression. Breathing becomes difficult for the affected person and the ability to cope with stress decreases significantly. This means that sporting activities are no longer possible for the affected person without further ado. The development of the child may also be delayed by the nasal polyps. Treatment can be carried out with the help of sprays and other medications. However, only surgery can completely remove the nasal polyps so that the affected person can breathe freely again. However, there is no guarantee that the nasal polyps will not recur. The patient’s life expectancy is not affected by this disease.
When should you go to the doctor?
Headaches, impaired breathing, snoring, or a nasal speaking pattern are indications of an irregularity that should be investigated. If sleep disturbances, sniffles or increased fatigue occur, a doctor is needed. If the symptoms persist or increase, clarification by a physician is recommended. If there is a slight increase in body temperature, inner restlessness or irritability, a check-up visit to a doctor should be initiated. If pain persists or becomes more intense, a doctor should be consulted immediately. There is a risk of secondary symptoms such as attention deficits, concentration disorders and memory problems, which should be prevented. General performance declines and everyday obligations can no longer be performed as usual. In addition, no medication should be taken without consulting a physician. There is a risk of various risks and side effects. A tightness in the throat, a change in breathing technique due to existing problems, and the development of anxiety should be discussed with a physician. If there is concern about choking, a doctor should be consulted as soon as possible. If a loss of appetite is noted or if the affected person shows behavioral changes as well as abnormalities of demeanor, a doctor’s visit is advised. In addition to the physical irregularities, psychological problems may arise, which should be avoided.
Treatment and therapy
Depending on the severity of the nasal polyps, various treatment methods are used to combat them. For example, if nasal polyps are not yet well developed, they can be treated by administering tablets or nasal sprays containing cortisone. Homeopathy also provides active ingredients to help regress nasal polyps. However, surgical measures often become necessary: Such an intervention can be done by removing the nasal polyps through the nasal cavities. However, laser treatment is also possible; the use of the laser procedure should be able to reduce the risk of nasal polyps forming again after a successful surgical procedure. Surgical removal of nasal polyps often takes place as an inpatient procedure:
This means that the procedure is followed by a hospital stay of several days. If nasal polyps are very mild, surgical removal is sometimes possible under local anesthesia. During the follow-up treatment of nasal polyps, preparations containing cortisone are occasionally used.
Outlook and prognosis
The prospects of recovery for those affected are generally very good in the case of nasal polyps. It hardly matters whether the treatment is surgical or medicinal. The symptoms caused by the nasal polyps subsequently improve in about 90 percent of all cases that occur. In the best case, the disturbing mucosal growths heal completely. However, the exact course of a disease caused by nasal polyps largely depends on timely treatment by a specialized physician.As well as whether it really succeeds in completely eliminating the cause of the inflammatory process. After successful therapy, the prognosis for patients is usually good. The disturbing accompanying symptoms such as obstructed nasal breathing, recurrent headaches and increased sinusitis then usually disappear completely. However, depending on the underlying cause of the polyps in the nose, there is a relatively high probability that the problem will recur in affected individuals – this is referred to as recurrence. Often, several successive operations are then required to finally eliminate the growths in the nose. In about 10 percent of all cases of nasal polyps, complications such as injury or even inflammation may also occur. Overall, however, the recurrence rate is reported to be only 50 percent. Whereby, however, at least 90 percent of all operated patients observe a significant improvement in their symptoms.
Prevention
The main thing to prevent is further spread of existing nasal polyps. For this purpose, it may be important to consult an ear, nose and throat specialist, for example, in the event of complaints with nasal breathing. But the development of nasal polyps can also be partially prevented by treating diseases such as sinusitis or rhinitis at an early stage; because if these diseases take a chronic course, the risk of nasal polyps developing is increased. It may also be possible to avoid frequent exposure to air pollutants that irritate the mucous membranes of the sinuses by adopting a conscious lifestyle.
Follow-up
If the nasal polyps are surgically removed, consistent follow-up care is necessary to ensure the success of the therapy. In doing so, it is important not to affect the nasal mucosa. A large amount of secretion often forms after nasal polyp surgery. After about seven to ten days, the secretion formation subsides again. During this time, it is advisable not to blow the nose, because otherwise there is a risk of secondary bleeding. Instead, the secretion is gently dabbed off. After the procedure, the patient should avoid anything that can lead to an increase in nasal pressure. This includes physical exertion that raises blood pressure, bending the head in the anterior direction, or taking hot baths. Air travel should also be avoided. All of these activities that increase blood pressure increase the risk of secondary bleeding. It is important to drink plenty of fluids after nasal polyp surgery, even though this can sometimes cause pain. Drinking prevents mucus build-up in the nose and thus supports the healing process. If, despite all precautions, a nosebleed does occur, it is important to remain calm. Agitation increases blood pressure all the more, which in turn has a negative effect on the severity of the bleeding. In the case of a nosebleed, a sufficient amount of nasal drops or nasal spray is injected and an ice pack is placed on the neck. The affected person sits upright and should not clear his throat. Normally, the bleeding will subside quickly.
What you can do yourself
People suffering from nasal polyps, in addition to medical care, can take some very beneficial measures to help take care of the nose as well as support the healing process. Daily inhalation is recommended for all patients. This process can be done in the comfort of your own home with or without an inhaler. Saline or thyme should be used for inhalation to achieve the best results. It helps dissolve mucus as well as hardening and aids in the removal of pathogens. In addition, regular nasal irrigation, performed with the use of salt water, helps the sufferer. During this process, the nose is flushed. Showering the nose loosens existing incrustations on the nasal walls and supports the removal of existing pathogens in the nose. In addition, the affected person should drink plenty of fluids daily. Warm teas or non-carbonated water are recommended. The intake of sufficient fluid leads to moistening of the mucous membranes in the nose as well as in the throat area. This contributes to a thinning of the secretion and thus promotes the recovery process of the affected person. The nose should also be cleansed several times a day by blowing thoroughly. The colloquially known pulling up of the mucus in the nose should be avoided, as it can contribute to a hardening of the nasal mucus.
