Nasal polyps

About nasal polyps

Nasal polyps are shaped like teardrops. They develop singly or in clusters around the openings to your sinuses (air-filled spaces behind the bones of your face that open up into your nose). Nasal polyps often develop in the sinuses behind the bridge of your nose – called the ethmoid sinuses. They usually grow on both sides of your nose and can completely block your nasal passages.

Nasal polyps can happen at any age but are most common in men over 40. Children between two and 10 years old don’t usually get them.

Symptoms of nasal polyps

If you have nasal polyps, your symptoms may include:

  •  blocked nose
  •  runny nose
  •  sneezing
  •  mucus draining down the back of your nose into your throat (postnasal drip)
  •  loss of smell and taste
  • change in voice

You may get headaches and pain in your face around your eyes and cheeks. If the nasal polyps block your sinuses, they can cause sinus infection.

Causes of nasal polyps

The exact cause of nasal polyps isn’t known. They are linked to inflammation of the lining of your nose, so they may arise if you have had an ongoing sinus infection. They are also linked to a type of allergy to fungus in the environment, called allergic fungal sinusitis.

If you develop asthma as an adult, you’re more likely to develop nasal polyps. You’re also more likely to get nasal polyps if you’re intolerant to aspirin. 

Diagnosis of nasal polyps

If you think you have nasal polyps, visit your GP for advice. He or she will ask about your symptoms and examine you. Your GP may also ask you about your medical history.

If only one nostril is affected, your GP will refer you to an ear, nose and throat (ENT) specialist. You may need a biopsy of the polyp to make sure it's not a cancer.

Treatment of nasal polyps

If your nasal polyps are small, your GP may prescribe you corticosteroid nasal drops. This can help to reduce the size of the polyps. After this, your GP may prescribe a corticosteroid nasal spray to make sure the polyps don't grow back. Nasal polyps shrink in eight out of 10 people who use nasal drops or spray. It can take around six weeks before you notice any improvement in your symptoms.

If you have larger polyps, you may need a short course of corticosteroid tablets followed by a long-term prescription for a nasal spray. Corticosteroid tablets can cause side-effects so you should only take them for a short time.

Surgery

If your symptoms don’t improve or the nasal polyps completely block both your nasal airways, your GP will refer you to an ENT specialist for surgery. You may also need surgery if you regularly have sinusitis. This will reduce your risk of polyps coming back.

Your ENT specialist may ask you to have a CT scan of your sinuses to show the size of your nasal polyps and where they are. This helps him or her to decide on the best surgical treatment.
In polypectomy surgery, your surgeon usually removes your polyps under local or general anaesthesia. He or she uses an endoscope (this is a narrow, flexible, tube-like telescopic camera) to look inside your nose. After the procedure your surgeon or GP will usually prescribe corticosteroid drops or spray to prevent the polyps growing back.

Other types of surgery can clear out and open up your sinuses. Ask your ENT specialist for more information on different types of surgery.

Polyps grow back in around three out of four people after four years. If you think your polyps have come back, see your GP for advice.

Are nasal polyps in children linked to cystic fibrosis?

Answer

Yes, it's thought that nasal polyps may be linked to cystic fibrosis in children.

Explanation

If you think your child has nasal polyps, visit his or her GP for advice. The GP will ask you about your child's symptoms and do a physical examination. If your child's GP suspects he or she has nasal polyps, your child will be referred for a test for cystic fibrosis.

Most children with cystic fibrosis are diagnosed when they are still babies – two-thirds are diagnosed before the age of one. Cystic fibrosis affects organs in the body, particularly the lungs and digestive system, which become clogged with sticky mucus. This results in infections and inflammation, making it difficult to breathe and digest food.

People with cystic fibrosis have a large amount of salt in their sweat. Doctors diagnose cystic fibrosis in children with a sweat test to measure the amount of salt in your child’s sweat. A small amount of sweat will be collected from your child's arm. You will usually be given the results a couple of days after the test. If the sweat test shows that your child has cystic fibrosis, the doctor will discuss available treatments with you.

I've been prescribed corticosteroid nasal drops for my nasal polyps. Can I have a reaction to the medicine?

Answer

Yes, some people can have unwanted side-effects to nasal drops containing steroids.

Explanation

Corticosteroid nasal drops, such as betamethasone, are often used to help shrink nasal polyps.

Some people get dryness and irritation in the nose and throat when taking these medicines. Other possible side-effects include burning, stinging and itching. Corticosteroid nasal drops can also cause nosebleeds. Very occasionally, people get a headache or lose their smell and taste after taking the medicine.

Once you have finished your course of nasal drops and your nasal polyps have reduced in size, your GP may prescribe you a nasal spray to make sure that the polyps don't grow back.

Can nasal polyps change the shape of my nose?

Answer

Yes, nasal polyps can make both sides of your nose bigger. However, this is very rare and only happens if the nasal polyps grow very large.

Explanation

If you have nasal polyps, your GP will prescribe you treatment to help reduce their size. If your nasal polyps aren't treated, they can grow and could widen the bones at the top of your nose and change the shape.