Nasal Polyps

Diagnosis

A diagnosis of nasal polyps begins with evaluating symptoms, reviewing medical history, and performing a physical exam.

Tests to confirm nasal polyps may include:

• Nasal endoscopy. A narrow tube with a lighted lens or camera is used to look inside the nose.
• Imaging studies. CT scans help show the size and location of polyps deep in the sinuses and rule out other causes of nasal blockage.
• Allergy tests. Skin prick tests or blood tests determine whether allergies are contributing to ongoing inflammation.
• Test for cystic fibrosis. Children with nasal polyps may be tested for cystic fibrosis using a sweat test, which checks whether sweat is saltier than normal.
• Blood tests. These can detect conditions linked to nasal polyps, such as immune system problems or allergies.

Treatment

Treatment for nasal polyps focuses on reducing symptoms, controlling inflammation, and improving quality of life.

Medicines

Options may include:

• Nasal steroids. Sprays such as fluticasone, budesonide, mometasone, triamcinolone, beclomethasone, or ciclesonide help reduce swelling.
• Oral steroids. Pills like prednisone may shrink polyps when nasal sprays are insufficient. They are generally prescribed for a short period due to potential side effects.
• Steroid shots. For severe polyps, injections may be used to reduce inflammation.
• Biologic medicines. Medications such as dupilumab, mepolizumab, and omalizumab target specific proteins to decrease swelling and irritation.
• Other prescription medicines. Antihistamines for allergies, antibiotics for infections, or aspirin desensitization for people with nasal polyps and aspirin-sensitive asthma.

Surgery

Endoscopic sinus surgery is considered when medications do not adequately shrink or remove polyps.

• Endoscopic surgery. A small tube with a lighted lens is inserted through the nostrils, allowing the surgeon to remove polyps and correct sinus openings.
• Balloon ostial dilation. This procedure enlarges sinus openings without removing tissue.

Post-surgery care may include corticosteroid nasal sprays to prevent recurrence and saline rinses to promote healing.