Nasal polyps: When is surgery needed?

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor of Otolaryngology - Department of Medical Examination and Internal Medicine - Vinmec Ha Long International Hospital. The doctor has more than 10 years of experience in examining and treating ENT diseases of adults and children.

Nasal polyp surgery is indicated for large polyps, when the use of drugs is not effective. The type of surgery depends on the number and location of polyps.

1. What are nasal polyps?

Nasal polyps are conditions that occur in the lining of the nose and the sinuses, which are the four empty spaces above and behind the nose. However, nasal polyps are not usually considered pathological. More precisely, this is the result of an inflammatory response caused by a bacterial or viral infection, an allergy, or the body's immune response against the fungus. Chronic inflammation increases the permeability of blood vessels in the lining of the nose and sinuses, causing water to accumulate inside the cells. Over time, under the influence of gravity, these water-filled tissues are pulled downward, forming polyps.
Symptoms of nasal polyps are similar to those of allergic rhinitis or chronic sinusitis, including difficulty breathing, persistent runny nose, and change in smell. Benign soft tissue buds that form from the lining of the nose and sinuses are the cause of the symptoms. They can also cause dull headaches and snoring. In rare cases, nasal polyps that are too large can alter the shape of the face somewhat.
The cause of the onset of inflammation is not entirely clear yet. Nasal polyps can affect anyone, but are more common in people over 40 and in children with conditions such as asthma, chronic sinusitis, seasonal runny nose, and cystic fibrosis.
Medical treatment (medication) is the most commonly used measure when treating small polyps. Nasal polypectomy is used for large polyps, but this condition often recurs, even after surgery.


Image of nasal polyps
Image of nasal polyps

2. When should nasal polyps go to the doctor?

Nasal congestion, runny nose and impaired sense of smell are common symptoms of nasal polyps. On the other hand, they are also typical symptoms of many other conditions and diseases, such as the flu.
However, the symptoms of the flu will usually go away after a week, while the symptoms of polyps will not subside but continue to appear for a long time. Therefore, when you notice symptoms of shortness of breath, runny nose and persistent runny nose, you may think that you have nasal polyps and need to see a doctor.

3. When to have nasal polyp surgery?


Nasal polyp surgery is indicated when the polyp size is too large and when medications are not effective
Nasal polyp surgery is indicated when the polyp size is too large and when medications are not effective

In many cases, doctors need to surgically remove nasal polyps. Indications for nasal polyp surgery when polyp size is too large and when medications do not prove effective. For patients with cystic fibrosis who have nasal polyps that are resistant to corticosteroids (an anti-inflammatory drug), nasal polypectomy is the only option. The type of surgery depends on the number and location of polyps. Polypectomy options include:
Polypectomy For small and solitary polyps, the doctor can easily remove them with a small mechanical suction device or a microdebrider. ). This technique, called nasal polypectomy, is done on an outpatient basis. After surgical removal of nasal polyps, the accompanying inflammation must be treated, usually a nasal spray containing corticosteroids and sometimes antibiotics and oral corticosteroids to support the treatment. Endoscopic sinus surgery is a broader technique that not only removes polyps but also opens up the part of the sinuses where nasal polyps form. If the sinuses are blocked and inflamed, the sinus cavity needs to be enlarged. In either case, your doctor will use a hard, thin tube with a camera attached, called an endoscope. Because endoscopic nasal polypectomy only makes very small incisions, the incision will heal quickly and cause less pain and discomfort than other types of surgery. Even so, full recovery after nasal polyp surgery can take up to several weeks. Nasal polyps even with radical surgical treatment still carry a risk of recurrence, requiring repeat surgery. .
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