Nasal Polyps Surgery

Nasal Polyps Surgery – A Viable Alternative?

Nasal Polyps Fact File: Nasal polyps are soft, transparent, non-cancerous growths that occur in the inner lining of the nasal passages or within the gaps of the sinuses. By themselves, they are harmless, but when they grow larger in size or form clusters, they block the nasal drainage system and sinuses, causing a variety of symptoms like snoring, lack of sleep, loss of sense of smell/taste, breathing difficulties, facial pain, headaches, dizziness, blurred vision and in severe cases, facial distortion. Causes have not been fully identified, but triggers are frequent inflammation/irritation of nasal passages due to allergens, asthma attacks or colds. Reduced immunity/genetic factors may play a role.

Historical Evidences: As far back as 4000 years ago, nasal polyps were first recorded. Ancient Egyptian and Hindu texts describe rhinologic procedures. It was also well-documented by the Ancient Greeks, especially Hippocrates, the father of modern medicine who gave the name “polyp” to these nasal growths as they resembled the sea polyps. No clear understanding was available about causes, though several treatments were practiced for their removal. Hippocrates, a specialist in rhinology, along with other famous physicians and surgeons of the ancient world like Galen, Paulus Aegineta etc established surgical procedures known as “Polypectomy” or nasal polyps surgery.

Symptoms of Nasal Polyps: The signs/symptoms of nasal polyps can easily be confused with many other conditions. Allergies, common cold, chest congestion, breathing problems, etc. are some of the main issues faced by sufferers. Unless polyps are large in size or number, they may go undetected. However, if all these are present along with post-nasal drip, loss of smell, hyaline mucus, pain extending into the dental arch, tightness around the forehead etc. then it’s wise to get a specialist’s opinion.

When to consult an ENT/Otolaryngologist: If your symptoms have lasted for more than ten days and seem to be worsening, leading to severe difficulty in pursuing your normal routine/daily life, it’s better to seek a specialist’s opinion. Your GP may recommend a consultation, based on such signs and symptoms.

Demographic profile of Nasal Polyps Sufferers: Though nasal polyps can occur at any age, research studies show that they’re more in young and middle-aged adults. Children rarely develop nasal polyps and if they do, it could be a sign of a more serious disease like cystic fibrosis, etc. More men than women tend to develop this condition but data is inconclusive. There are more sufferers in developed countries than in less developed ones, leading to the tentative conclusion that increased pollutants and allergens may play a role in developing nasal polyps. There is an increased frequency of nasal polyps in patients with general airway diseases. One of the issues faced by sufferers is that many of them are unaware of their condition as it gets diagnosed only at an advanced stage.

Risk Factors: It may lead to Churg-Strauss syndrome, a serious illness that involves the blood-vessels, and other conditions like asthma, aspirin allergy, non-steroidal anti-inflammatory drugs like ibuprofen, naproxen intolerance, reduced immunity to fungal infections, chronic respiratory problems etc. Hence, one of the important treatments for this condition is nasal polyps surgery.

Potential Issues: Sleep apnea, sinusitis, vulnerability to eye diseases and even meningitis are some of the worst case scenarios that have to be considered.

Diagnosis: As mentioned earlier, an ENT specialist can conclusively identify nasal polyps. However, if they are large in size, they may be visible to the naked eye or to your GP’s lighted instrument. Other decisive methods of identifying them are through advanced instrumentation like nasofibroendoscope, which allows a painless examination with digital camera. CT scan of the nasal area, allergy tests etc are also part of the multi-disciplinary diagnostic process.

Medical Intervention: Initial treatments include cortico-steroid nasal sprays, anti-histamines etc. Nasal polyps surgery is recommended in severe/chronic cases. Two types are available, depending on the size and location of polyps. Polypectomy is used for smaller/isolated polyp removal via a microdebriber. Endoscopic surgical procedure via digital camera is another technique, which is used in case of large polyps involving the sinuses.

While nasal polyps surgery is useful in some clients, it’s less effective in the case of asthma patients with increased sensitivity to aspirin and does not guarantee the non-recurrence.