Therapy

Since the polyps unfortunately do not regress themselves, they often have to be surgically removed. This involves clearing out the polyps via the nose and simultaneously widening the exits of the paranasal sinuses. After this procedure, patients are recommended to clean their noses regularly by inhalation, nasal rinsing and nasal showers (Emser Sole®).

This procedure is risky in that the nasal mucosa is very well supplied with blood and one complication of the operation is postoperative bleeding. If an allergy is responsible for the development of nasal polyps, it should definitely be treated afterwards. This includes:

Antihistamines
Nasal sprays containing cortisone
In the longer term, a hyposensitization therapy.

Various homeopathic remedies are available for the supportive treatment of polyps, but the main aim is to alleviate accompanying symptoms, strengthen the immune system or reduce inflammatory reactions.

If the polyps have already developed, they cannot be eliminated by homeopathy and therefore homeopathy does not replace treatment by a doctor. Known remedies of homeopathy in the treatment of polyps are A homeopathic treatment should always be supervised by a doctor or alternative practitioner with additional training in homeopathy, who can find the appropriate remedy and the right dosage for the ailment.

Calcium phosphoricum: For lively, sensitive and thin children
Calcium carbonicum: For sluggish, plump children who are prone to shyness and fear
Thuja occidentalis: polyps in nose, colon or uterus and patients susceptible to colds

If the conservative therapies (steroids or antihistamines for ingestion/application) do not bring the desired result, a surgical therapy can be tried.There is the endonasal (through the nose) polypectomy and the endonasal operation of the paranasal sinus with simultaneous removal of the polyps.

As with all operations, before the polyp operation, the intake of medication, especially blood thinners, should be discussed with the treating physician and stopped if necessary to avoid complications during and after the operation. Endonasal polypectomy This surgical technique is mainly used in older patients when a major surgery is not feasible, for example, due to the patient’s poor general condition. It is performed on an outpatient basis.

This surgical technique often leads to recurrences (the recurrence of polyps) after a short time, as the “root” of the polyp remains in the mucous membrane. In most cases, a complete removal of polyps and the diseased mucosa is recommended. During this procedure, the surface of the mucous membrane is locally anesthetized.

In addition, a vasoconstrictor is used, a drug that constricts the blood vessels and thus makes the polyps more easily recognizable and reduces bleeding. If the polyps are pedunculated polyps, which are elongated and narrow at the base, they are wrapped with a metallic loop and tied off in the area of the middle nasal passage until they are separated from the base and pulled out through the nose. For polyps with a broad base, a nasal forceps or a so-called conchotome is used for ablation.

Choanal polyps, which are formed by mucosal cells from the maxillary sinus, one of the paranasal sinuses, and grow into the middle nasal passage, are a special feature. These polyps are removed using the so-called blunt hook according to Lange. The stem of the polyps is grasped, torn through with the hook and the polyp is pulled out through the nose.

However, even with this type of polyp, complete removal with affected mucous membrane is recommended, as otherwise recurrences may occur. After the operation, the nasal mucosa must be treated with irrigation and inhalation to prevent crusts or swelling. Risk: Bleeding and infections, as well as injuries to the nerves and surrounding structures are a possible surgical risk.

Endonasal surgery of the paranasal sinuses with polyp removal This surgical technique requires an inpatient stay of about one week and general anesthesia. The inability to work depends on the type of profession and lasts about two weeks. In this operation, an endoscope is used again and access to the frontal sinus is made possible by removing the anterior ethmoidectomy.

Now the tissue is either partially (fenestration) or completely removed, this is called reconstruction. This is performed for the frontal sinus, sphenoidal sinus and maxillary sinus. The operation can be performed with removal of polyps, correction of the nasal septum (septum correction) or removal of palatal tonsils, as well as reduction of the size of the nasal conchae to improve the ventilation of the nose and its sinuses and promote the subsiding of the inflammation.

After the operation, moustaches are initially prohibited. The inserted tamponade for hemostasis is removed by the doctor after about 1-3 days. Risk: The procedure is very demanding and, as with any operation, post-operative bleeding, infection and injury to nerves and surrounding structures can occur.

Bleeding is not uncommon during this operation and may have to be electrically sclerosed (coagulated). Due to the close proximity to the brain and meninges, encephalitis or meningitis can occur. A possible injury to the base of the skull is accompanied by a discharge of cerebrospinal fluid through the nose (CSF) and must be treated immediately.

The eye muscles and their nerves or the optic nerve can also be injured or affected by an infection. Bleeding into the eye socket can also occur. Furthermore, there may be a (temporary) deterioration of the sense of smell. Because of these risks, although extremely rare, the patient is monitored very closely after the operation. Mild headaches and head pressure, as well as bruising or swelling are more common.