Nasal Polyps: What They Are, Symptoms, Types, and Diagnosis

A familiar picture: a person spends a month being treated for a "lingering cold," the nose is still blocked, smells have almost disappeared, and family members complain about snoring. Sometimes what lies behind this is not a runny nose but nasal polyps — soft growths of the mucous membrane that do not hurt but make it hard to breathe. Let us calmly sort out what these formations are and how doctors see them.

What nasal polyps and nasal polyposis are

A nasal polyp is a polypoid mass that mainly arises from the mucous membrane of the nose and paranasal sinuses. Simply put, it is an overgrowth of the mucous membrane: soft, insensitive to touch, easily displaced. It is not cancer.

What happens inside. Polyps grow anywhere in the mucous membrane of the nose or sinuses, often where the sinuses open into the nasal cavity. Small ones give no sign of themselves; large ones block nasal breathing and the outflow from the sinuses. Doctors do not know the exact cause; they suggest that growth is linked to prolonged swelling and inflammation against a background of allergy, asthma, or infection.

What nasal polyps look like

A polyp is soft, painless, and easily displaced. On examination it looks like a grayish formation resembling a grape in the nasal passage. There may be a single one, or there may be multiple.

Symptoms of polyps in adults

Small polyps may cause no symptoms at all. Beyond that, the picture resembles a permanent cold — the person feels as if their nose is always blocked. What to look for:

• nasal congestion and a feeling that the nose is stuffed up;
• runny nose, sneezing, a sensation that mucus is slowly running down the back of the throat;
• reduced sense of smell and taste, up to their loss;
• snoring at night, and if sinusitis develops — headache and pain in the sinus area.

The difference from a cold is simple: a cold passes within a few days, while polyps do not disappear without treatment. If the growths block the sinus ostia, symptoms of sinusitis are added to the congestion.

Types: antrochoanal and ethmoidal polyps

An antrochoanal polyp grows from the maxillary sinus. It is less common, usually single and on one side. Ethmoidal polyps come from the ethmoid labyrinth: as a rule, there are many of them and they are on both sides.

What happens inside. A unilateral polyp of irregular shape, especially if it is painful or bleeds, requires urgent examination: this is sometimes how an intranasal tumor looks. Nasal polyps have nothing to do with polyps of the intestine or uterus.

What is associated with an increased risk: asthma, intolerance to aspirin and other nonsteroidal anti-inflammatory drugs (this is a pseudoallergy, not a true allergy), chronic sinusitis, cystic fibrosis, hay fever, deviated nasal septum, narrow nasal passages. The combination of such intolerance, polyps, and asthma is called Samter's triad. After removal, polyps often return — in about 70% of cases.

Nasal polyps in children and adenoids

Nasal polyps are rare in children. More often, this word hides confusion with adenoids (adenoid vegetations) — an enlarged pharyngeal tonsil. If a true polyp is found in a child, the doctor looks for the cause: about one third of children with mucoviscidosis (cystic fibrosis) also have nasal polyps, because the glands secrete too viscous a secretion.

How they are diagnosed and when a doctor is needed

The examination begins with the nose and mouth. Then an ENT doctor (otolaryngologist) with special instruments. Nasal endoscopy may be needed: a thin tube helps to see the full extent of the growths. Sometimes a CT scan of the paranasal sinuses is ordered — polyps appear as darkened areas, and in long-standing cases part of the bone inside the sinuses may be destroyed. The doctor assesses the size of the polyps, their location, whether the process is unilateral or bilateral, and accompanying diseases — further management depends on this.

You should see a doctor if you suspect polyps, if it is difficult to breathe through the nose, if symptoms worsen, or if your sense of smell has changed.

Polyps themselves are not a reason to call an ambulance; 103 or 112 — if, with pronounced sinus inflammation, signs of damage to the orbit or meninges appear (meningitis, encephalitis).

This material is for reference purposes and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer