What are nasal polyps?

Nasal polyps are small growths of tissue in your nose or sinuses. They are not painful, but they can often cause intrusive symptoms in many patients. Approximately 12% of the population is affected by chronic rhinosinusitis (CRS) or inflammation of the nose and sinuses. Nearly 20% of those affected by CRS have nasal polyps that contribute to their symptoms.

What is the cause of nasal polyps?

Nasal polyps are caused by chronic inflammation and can be associated with many allergic diseases. For example, asthma, allergic rhinitis (hay fever), aspirin sensitivity, repeat infections, etc. Although the exact cause is unknown, when a biopsy (sample of the tissue) is taken of the polyps, there are high levels of the allergic white blood cells known as eosinophils.

How are nasal polyps diagnosed?

Polyps can be diagnosed clinically on a physical exam by a doctor, nasal endoscope, or on an imaging scan of the sinuses (i.e. CT scan or MRI). The symptoms are usually based on the size of the polyps and often cause runny nose, nasal congestion, postnasal drip, difficulty breathing, although some patients may not be symptomatic. As specialists here in the Salt Lake Valley, we worry about nasal polyps in patients that have decreased smell or taste not secondary to a COVID infection. Individuals who do not respond well to allergic rhinitis and/or sinusitis treatment may have underlying nasal polyps that are limiting recovery.

How are nasal polyps treated?

There are many treatment options for nasal polyps. The most important and potent treatment is daily intranasal steroids (i.e. Flonase, Nasacort, Rhinocort, Nasonex, etc.). There is also fluticasone breath-powered corticosteroid device called Xhance that is FDA approved for CRS with nasal polyps.

Surgery by an Ear Nose and Throat doctor can provide rapid relief. Unfortunately, this relief is usually temporary as many patients will have recurrent nasal polyps within the next few months or even years.

Other supportive treatment includes management of associated allergies with allergen immunotherapy, antileukotriene therapy, aspirin desensitization, and daily lavage of the sinuses where appropriate. If nasal steroids and supportive treatment are used in conjunction with surgery there is a much lower rate of recurrence.

Finally, the newest treatments include injectable medications known as biologics. These are highly targeted therapies that reduce polyp size and symptoms including Dupixent (Dupilumab), Xolair (Omalizumab), and Nucala (Mepolizumab).

What are the complications of nasal polyps?

Nasal polyps can cause a few complications due to blockage of the normal airflow and fluid drainage. The most common complication is recurrent sinus infections; however, asthma flare-ups and obstructive sleep apnea can also be complications of large nasal polyps. Diagnosis and treatment of polyps can minimize the risk of complications and improve patients’ quality of life.

Allergy Associates of Utah is an allergy, asthma, and immunology specialty clinic serving the greater Salt Lake City, Utah area with 2 convenient locations in Murray and West Jordan. Led by specialists Andrew Smith, MD, MS, and Tara Sarin, MD, the practice strives to help people of all ages and background achieve success. Request an appointment by phone or online at either Allergy Associates of Utah location for expert allergy and immunology care today.