Overview of Nasal Polyps

Chronic rhinosinusitis with nasal polyps is a complex health issue which affects 1-4% of the general population.

 Nasal polyps most often present with symptoms of:

• Decrease, alteration, or total loss of sense of smell

• Nasal airflow obstruction or “stuffiness”

• Discolored nasal drainage

• Facial pressure and discomfort or headaches

While the disease process is not fully understood, there is a strong association of chronic nasal and sinus inflammation in the development of these nasal polyps. Chronic sinus infections and chronic allergic inflammation are common examples of inflammation sources, however there are less common disease processes such as cystic fibrosis which can be associated with nasal polyps as well. Therefore, there are a wide variety of clinically proven treatment options which are aimed at shrinking or removing the polyps and resolving the physical obstruction caused by them as well as treating the underlying source of chronic inflammation.

 Types of medication management options for this issue include:

• Steroids

  • Common examples of these include oral tablets like Medrol Dosepaks and Prednisone, but there are injectable, IV, and dissolvable implants that can all effectively deliver steroids as well. Steroids produce a broad range of antiinflammatory effects, but great care is needed with use of these medications as they have a large number of potential side effects and adverse effects.

• Antihistamines

  • Most people are familiar with some of the over the counter antihistamine pills such as Benadryl, Claritin, and Zyrtec. However, there are several other options for active ingredients and even other delivery forms altogether such nasal sprays and eye drops which can contain antihistamines.

• Antibiotics

  • Standard antibiotics such as Augmentin, Bactrim, and Omnicef can be given with modified dosing schedules in order to more fully eradicate any chronic bacterial infection

• Leukotriene inhibitors

  • The primary form of this is Montelukast. It works well as another alternative chemical pathway to reducing certain kinds of inflammation

• Monoclonal antibodies

  • Also known as “biologics”, these are one of the newest types of medications to be available for nasal polyps. These injectable medications use modified antibodies to specifically target and inhibit very select and specific immune system pathways to reduce nasal polyps effectively

Unfortunately, not all sinus disease or polyps are manageable with medications alone. In these cases, endoscopic sinus surgery can be used to physically remove the polyps and fully open the sinuses to yield a significant level of relief. Removing the polyps helps to directly reset patient’s back to their normal baseline, and correcting any sinonasal obstruction at the same time will allow the sinuses to drain mucus properly and increase the physical accessibility of the sinuses for common maintenance therapies.

 If you have been diagnosed with nasal polyps or are concerned that you may be experiencing this issue and would like to pursue further diagnostic evaluation and management, call our office at 404-255-2918 to schedule an appointment.

Author

Aaron Nakano, NP Nurse practitioner Aaron specializes in otolaryngology managing the full spectrum of ENT conditions at Atlanta ENT, Sinus & Allergy Associates, P.C. He provides his patient-tailored services through the Sandy Springs location in Atlanta, Georgia.

 

Ramie A. Tritt, MD Ramie A. Tritt, MD, FRCSC, specializes in nasal and sinus surgery as well as snoring and sleep apnea surgery at Atlanta ENT, Sinus & Allergy Associates, P.C.’s Sandy Springs location in Atlanta, Georgia. Dr. Tritt graduated from medical school with honors from McGill University in Montreal, Canada. He completed his otolaryngology residency at McGill University and his fellowship in otology and head and neck surgery at Upstate Medical Center in Syracuse, New York. He is a diplomate of the American Board of Otolaryngology and a fellow of the American Academy of Otolaryngology-Head and Neck Surgery, and the Royal College of Physicians and Surgeons of Canada. Dr. Tritt is a member of the Medical Association of Georgia and the American Academy of Otolaryngology-Head and Neck Surgery. Dr. Tritt has been an instructor at national ENT meetings, a Medical Advisory Board member for computer image-guided sinus surgery, and been recognized by Atlanta Magazine as a “Doctor Who Doctors Go To”.