Dr Annabelle Leong has provided an excellent summary on what nasal polyps are and their link to sinus issues. Hence, I shall not be repetitious. I would however like to add on the following points about nasal polyps that I hope may be of use to you:
1. Nasal polyps, although often benign and are due to chronic sinusitis (inflammation or infection of the sinuses lasting longer than 3 months), can cause significant impact in terms of
- Quality of life - Studies have shown that the discomfort and impairment to the quality of life of a patient with chronic sinusitis (with or without nasal polyps) can be similar to that of a patient with arthritis, cancer, asthma, and inflammatory bowel disease
- Economic impact - Sufferer from nasal polyps may experience frequent sinus infections due to a higher tendency for blocked sinuses. This may result in increased visits to GPs or ENT Specialists, significant time off work and reduced productivity.
- Impact on lower respiratory tract problems (lower airways)- The nose and sinuses (part of the upper airway) and are connected to the windpipe and lungs (lower airways). Hence, problems in the nose and sinuses can affect the lungs too. Inflammation or infection in the nose and sinuses can track down to the lungs. This condition is often called "United Airway Disease" in which uncontrolled sinusitis (often worse if there is nasal polyps) or allergic rhinitis can worsen or exacerbate Asthma or Bronchitis.
- Impact on obstructive sleep apnoea (OSA) - This is a condition in which the sufferer "stops breathing" for a short period of time during sleep. The nose and sinuses are part of the upper airway. Hence patients with nasal polyps are at a higher risk of having OSA. To find out more about OSA, do read my article which was published on Human.
- Impact on ears and throat - As the nose are intimately connected to the ear and throat, it is not uncommon for patients with nasal polyps to have blocked ears (from a blocked or dysfunctional eustachian tube, resulting in fluid in the middle ear, aka "glue ear") or laryngitis (inflammation of the voicebox resulting in hoarse voice, sore throat or cough usually due to backdrip from the nose & sinuses, aka "postnasal drip")
2. A recent study has shown that patients with chronic sinusitis with nasal polyps are more likely to fail medical treatments compared to those without nasal polyps. Having said that, I do have quite a number of patients whose nasal polyps are adequately controlled with medications alone.
For my patients who continue to have troubling symptoms despite being placed on maximal medical management, especially those who have concurrent lower respiratory problems (e.g. Asthma, Bronchitis or Chronic Obstructive Pulmonary Disease (COPD)), I do suggest that they have their polyps cleared surgically (in a minimally invasive procedure called functional endoscopic sinus surgery, aka "FESS").
The aim of the surgery is to remove the polyps (to reduce the "inflammatory load"), unblock and drain the sinuses and allow application of medications (e.g. steroid solutions) into the sinuses to keep the polyps under control.
3. There is a tendency for nasal polyps to recur. Having said that, majority of patients do feel much better after having their polyps removed (better in terms of severity of symptoms or frequency of sinus infections).
Also, with regular followup and surveillance, early recurrence can be controlled with medications or application of antibiotic or steroid solutions into the sinus cavity in the clinic (this is not possible in unoperated sinuses).
If you have been told that you have nasal polyps, I would highly recommend that you consult an ENT Specialist for an assessment and treatment. Hope this helps and all the best!
