What is the link between nasal polyps and sinus issues?

Doctor's Answers 2

I'm sorry to hear that you have been suffering from sinus issues your whole life!

I am pretty sure that your nasal polyps are part of the underlying cause of your sinus problems as this link is well-documented. Nasal polyps are usually benign inflammatory growths which arise from the thickened lining of your sinuses.

As the nasal polyps grow larger, they start to block off the openings of the sinuses, preventing from draining properly and resulting in the trapping of thick mucus inside the sinuses.

Bacteria and viruses can easily grow in these pools of mucus, leading to frequent infections of the sinuses, so that you suffer:

  • headaches
  • blocked and runny nose
  • smelly yellow/greenish nasal discharge
  • postnasal drip causing you to cough and clear your throat constantly

Sinus infections can make you quite unwell with fever and facial pain too. When nasal polyps are large, they also make it difficult for you to breathe through your nose and quite likely, your voice will sound like you constantly have a cold because of this nasal obstruction.

Funnily enough, nobody truly knows what the true cause of nasal polyps are, although many studies speculate that they may be due to underlying nasal allergies.

Previous studies even hinted at a fungal source of infection causing the growth of nasal polyps.

If you are plagued by so many sinus problems and you already know that you have nasal polyps, I presume that you very likely have already undergone a flexible nasal endoscopy/camera procedure in clinic to examine the insides of your nose and sinuses. This is painfree and easy enough to perform.

To shrink nasal polyps, we usually prescribe nasal medications like steroid sprays, or if they are very large, sometimes a course of steroid tablets, in addition to antibiotics to treat the sinus infection.

If these medications do not help to shrink your polyps and if your sinus infections do not improve, then the next option is to consider surgical removal of the nasal polyps to clear the obstruction and allow the sinuses to drain freely once again.

Surgery is minimally invasive, quite straightforward and is performed with the help of an endoscope/camera inserted into the nose. It may be done as a daycase procedure under a short general anaesthetic but many patients prefer to stay in hospital overnight and go home the next day.

So the answer to your question is quite simple really: Yes, those nasal polyps are the likely cause of your sinus infections and if medications don't help you anymore, then yes, you should consider having those polyps removed.

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!

Similar Questions

Can you recommend any ENT specialists in Singapore?

Many of my patients, friends and even my own family members often blame their nose problems on their “sinus”. Many people are unaware that sinuses are part of the normal anatomy in their face. Sinuses are air-filled cavities surrounding the nasal cavity and everybody has them! The lining of the sinuses produce mucous that drains into your nose. Nobody really knows why but there are theories that sinuses: Make your head less heavy (imagine if your skull has no hollow spaces, it must be very heavy!)

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Answered By

Dr Eng Cern Gan

ENT Doctor

Why do I always get runny nose in the morning? How can I get rid of it?

Thank you for your question. I will address the question in a few sections: “Sinus” vs Sinusitis – What is the difference? “Sinus” is a common term that many people incorrectly use to describe nose symptoms such as: Frequent blocked nose Runny nose Sneezing Sinuses are hollow spaces that surround the nasal cavity. Everyone has them and it is a normal part of the anatomy in your face. The lining of these spaces (called mucous membranes) produces mucous that drains into the nose.

Photo of Dr Eng Cern Gan

Answered By

Dr Eng Cern Gan

ENT Doctor

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