Noncancerous growths inside the nose or sinuses are known as nasal polyps (NP). Runny nose, loss of smell, difficulty breathing through the nose, diminished taste, and post nasal drip are symptoms. The developments are sac-like, mobile, and unpainful, though they may occasionally cause facial pain.
They typically afflict people who are impacted in both nostrils. The nose may enlarge and sinusitis is both potential complications.
The precise cause is not known. They might be connected to long-term sinus lining irritation. People with allergies, cystic fibrosis, sensitivity to aspirin, or specific infections are more likely to experience them.
The polyp itself is a manifestation of mucous membrane expansion. Looking up the nose can be used to diagnose. The number of polyps can be determined and surgical planning assisted by a CT scan.
Nasal polyps are assumed to be caused by repeated infection or inflammation, while their exact etiology is uncertain. The lining of the sinuses gives rise to polyps. Due to the accumulation of extracellular fluid, the nasal mucosa becomes inflamed, especially in the middle meatus region.
This extracellular fluid buildup leads to the development of polyps and their protrusion through and into the sinuses or nasal cavity. Initially, sessile polyps become pedunculated as a result of gravity.
The underlying mechanism in those who develop nasal polyps as a result of sensitivity to aspirin or NSAID is caused by problems with arachidonic acid metabolism. Aspirin and other cycloxygenase inhibitors cause products to be shunted through the lipoxygenase pathway, increasing the generation of substances that promote inflammation.
These inflammatory substances cause nasal polyp growth and asthma symptoms including wheezing in the airways.
Nasal polyps frequently accompany other chronic conditions and might remain for a very long time. Even after receiving medical attention or being surgically removed, they can reappear.
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WHAT CAUSES NASAL POLYPS?
Nasal polyps develop in irritated nasal mucosa tissue. The mucosa is a very moist layer that protects the sinuses and the interior of your nose while also adding moisture to the air you breathe.
The nasal mucosa swells and turns red when an infection or allergy-related irritation occurs, and it may also secrete fluid that drops out.
A polyp may develop on the mucosa after continuous inflammation. A polyp is a spherical growth that resembles a little cyst and can obstruct the nasal passages.
There is frequently a catalyst for acquiring polyps, even though some people can get them without having had any nasal issues in the past. Among these triggers are:
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Persistent or ongoing sinus infections:
You can have chronic sinusitis, also known as chronic rhinosinusitis or CRS, if your “infection” lasts for weeks or months. Due to this disease, you are more likely to develop nasal polyps. In actuality, 20% of the millions of sufferers of chronic sinusitis worldwide also have nasal polyps.
Although it can affect anyone at any age, chronic rhinosinusitis with nasal polyps (CRSwNP) most frequently affects persons in their 30s and 40s.
If you have sinus pressure, a runny or stuffy nose, or a loss of taste or smell for 10 days or longer, let your doctor know.
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Asthma:
Nasal polyps can be present in up to 39% of people with adult-onset asthma. Nasal polyps with concomitant asthma, or “NPcA,” is the medical term for the condition. One of the most severe combined airway diseases is NPcA.
Nasal polyps can increase your risk of acquiring asthma, but the relationship is reciprocal—up to 45% of people with nasal polyps go on to acquire adult-onset asthma.
Anyone with asthma should visit their doctor frequently to ensure effective asthma control, including the appropriate therapy of concomitant illnesses.
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Allergic rhinitis (hay fever):
Nasal irritation brought on by an allergic rhinitis, often known as a nasal allergy, can result in nasal polyps. The two basic kinds of allergic rhinitis are as follows. Pollen from grass, weeds, and trees causes seasonal allergic rhinitis, or hay fever, which typically occurs in the spring and fall.
Year-round exposure to dust mites, mildew, and animal dander can cause perennial allergic rhinitis. Similar to the ordinary cold, allergic rhinitis symptoms stay longer and frequently entail more irritation in the nose and eyes.
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Cystic fibrosis:
A hereditary condition known as cystic fibrosis, or CF, results in mucus build-up in the body and airway obstruction.
This results in nasal polyps, breathing issues, and lung infections. Up to 60% of persons with cystic fibrosis experience the development of nasal polyps.
Cystic fibrosis can be identified by a number of different tests, and 75% of cases are identified by the time a child reaches the age of two.
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Churg-Strauss disease
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Fungal sinusitis:
Environmental fungi can result in allergic fungal sinusitis (AFS). Fungi produce nasal inflammation similar to an allergy. They also hinder or slow down sinus mucus flow. Nasal polyps and persistent sinusitis are two complications of AFS. Thick, sticky mucous is one indication of AFS.
Your doctor can quickly sample your mucus and check for AFS in it. A thorough diagnosis is crucial since untreated AFS can harm your eyesight and sense of smell.
Although allergic fungal sinusitis can occur at any age, it is more frequent in adolescents and young adults.
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Susceptibility to NSAIDs, such as aspirin or ibuprofen, which are non-steroidal anti-inflammatory medicines:
Life-threatening breathing issues brought on by aspirin sensitivity may worsen nasal inflammation and promote the growth of nasal polyps. Aspirin-exacerbated respiratory disease is characterised by a sensitivity to aspirin or another non-steroidal anti-inflammatory medicine (NSAID), chronic sinusitis, and asthma (AERD).
The conditions other frequent names are Sampter’s Triad and ASA Triad. Desensitization to aspirin helps some persons with the illness.
Your doctor will begin by giving you a low dose of aspirin, which will then be gradually increased to build up your tolerance until your sensitivity is completely gone.
Some persons may have an inherited propensity to develop polyps. This might be a result of how their genes influence how their mucosa responds to inflammation.
BLEW A NASAL POLYP? HOW TO KNOW WHAT CAME OUT OF YOUR NOSE?
When do you know if you blew a nasal polyp?
Everyone, from the tiniest infants to the oldest individuals, has had a “runny nose” at some point. Snot is the most frequent name for the mucus that comes out of our noses. But occasionally your nose makes more than just mucus.
To decide whether to seek medical attention, it’s critical to understand the distinctions between mucus, pus, polyps, cerebrospinal fluid, and a foreign item.
So, continue reading to find out how you can determine whether something is snot or not.
Snot:
Excessive mucus (snot) is produced when a virus, allergy, or other irritant stimulates the goblet cells of the mucous membranes lining your nasal passages. This condition is known as nasal mucosal inflammation, and it causes a runny nose.
Nasal mucus often aids in removing germs and tiny particles from the air we breathe and blocking their entry into the lungs.
Cilia (little hair-like structures) push the mucus with the debris trapped in it to the back of the throat, where it is ingested and digested into basic nutrients, which are subsequently used by the body again.
Additionally, nasal mucus aids in preserving tissue moisture and humidifying incoming air before it enters the lungs.
Mucus is a primarily water-based gel-like material. Mucins, inorganic salts, proteins (including pathogen-killing enzymes), lipids, and mucopolysaccharides are only a few of the many materials it contains. Based on humidity, the existence of a sinus infection, sinus inflammation brought on by allergies, or environmental irritants, the ratio of these components may change. Due to these factors, mucus may differ in appearance.
The professionals in ear, nose, and throat are skilled at distinguishing between different kinds of mucus and compounds that aren’t actually mucus. If medical treatment is required, this procedure is crucial in deciding the best course of action.
Not snot:
Epistaxis or Blood in The Nose – Unless the trauma is involved, blood in the nose normally does not require medical treatment, but because of the large number of blood arteries in the nose, it can become a recurring issue.
Usually, dry nasal mucosa, nose picking, inflammation, allergies, high blood pressure, and/or anticoagulating drugs including Coumadin, Xarelto, Plavix, and aspirin cause recurrent or persistent nosebleeds.
The control of these factors frequently leads to a reduction in nosebleeds. It’s crucial to see an ear, nose, and throat specialist if your nosebleeds are frequent or persistent.
Despite the fact that most patients’ nosebleeds resolve on their own, some require temporary nasal packing or vascular cauterization to halt the bleeding.
Pus (Purulence)
Pus is a milky, sticky, thick, yellow or green, and frequently odorous substance. Along with mucus, this substance drains from your nose and is frequently a sign of an illness.
White blood cells that the body has dispatched to fight infection are highly concentrated in pus, along with dead cells and pathogen metabolites. Purulence can be brought on by both viral and fungal illnesses, although they don’t necessarily respond to the same medicinal interventions.
You should contact a doctor if pus is flowing from your nose, especially if it has been doing so for more than a week.
Nasal polyps:
nasal polyps are benign growths in the nose that are linked to long-term inflammation brought on by allergies, chronic sinusitis, or exposure to irritants in the environment (such as smoke or pollution).
A nasal obstruction caused by polyps might impair your sense of smell. Polyps can appear to be snot when they emerge from the shiny mucous membrane of your nose if you gaze into someone’s nose. For relief, polyps frequently need to be surgically removed.
CSF:
The fluid known as cerebrospinal fluid (CSF), which surrounds the brain and spinal cord, is usually contained within these areas by a protective layer known as the dura. CSF may leak through the nose as a result of a dura leak. These leaks are uncommon and frequently follow a traumatic or surgical occurrence.
Although it can happen, spontaneous CSF leaking through the nose is quite uncommon. A salty taste in the throat and a lot of clear, watery discharge from the nose, especially while raising or bearing down, are symptoms.
The fluid is typically collected and examined to obtain a certain diagnosis if a CSF leak is suspected. CSF leaks frequently stop with time and the right care, but they may require surgery to stop.
Foreign Body in the Nose:
Many foreign bodies, particularly those that have been present in the nose for a while, resemble snot.
Identifying the foreign body may be challenging since the nasal mucosa may be inflamed around it. Common foreign objects that can resemble snot include cotton, foam, paper balls, plastic toy bits, and toilet tissue, especially after several days in the nose.
WHAT ARE THE SYMPTOMS OF NASAL POLYPS?
If you blew a nasal polyp, you most definitely have experienced some symptoms related to it.
Soft, painless growths inside the nasal passageways are known as nasal polyps. They frequently happen where your nose’s upper sinuses drain (where your eyes, nose, and cheekbones meet).
Because polyps lack nerve sensitivity, you might not even be aware that you have them.
Polyps can enlarge to the point that they obstruct your nasal passages, causing persistent congestion. Some symptoms include:
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Feeling as though your nose is plugged
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Clogged nose
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Postnasal drip, or when too much mucus drips down your neck,
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Nasal congestion
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Nose congestion diminished perception of smell mouth breathing
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A pressing sensation in your face or forehead
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Sleep apnea
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Snoring
In addition to the polyp, a sinus infection may also cause pain or headaches.
DIAGNOSIS OF NASAL POLYPS
In rare circumstances, a medical professional can diagnose a nasal polyp by using an otoscope to visually inspect the nasal passages (a simple lighted tool usually used to look inside the ears).
Nasal endoscopy, which involves inserting a small camera into the nose to acquire a clearer view of the nasal passages, can be used to diagnose certain conditions.
Either nasal endoscopy or ocular examination can diagnose the majority of cases.
A CT scan of the sinuses may occasionally be required to make a diagnosis. Better disease characterization is made possible by the sinus CT scan, particularly in sinuses that cannot be accessible by endoscopy.
Additional diagnostic procedures might be required because people with nasal polyps frequently have other diseases present as well.
TREATMENT OF NASAL POLYPS
Nasal polyps can be treated surgically or with medications.
Large nasal polyps that cause recurring sinus infections frequently need to be removed by sinus surgery in more severe situations or when treatment is ineffective.
You can typically return home the same day after an endoscopic operation, which makes use of a long, illuminated tube that is placed through the nostril.
The optimal treatment for nasal polyps typically involves surgical treatments followed by medication treatments since this strategy lowers the likelihood that the polyps will recur.
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Sprays and drops:
Nasal sprays with topical steroids, like Flonase (fluticasone propionate) and Nasonex (mometasone furoate), can help shrink nasal polyps and stop them from returning after surgery.
In order to more effectively enter the nasal airways and reach the nasal polyps, some healthcare professionals choose to employ nasal steroid drops rather than sprays.
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Corticosteroids:
For those with severe symptoms, oral corticosteroids like prednisone can quickly reduce the size of nasal polyps.
However, topical nasal steroid sprays are typically able to regulate symptoms better and stop the polyps from becoming larger after a brief course of corticosteroids (approximately one to two weeks).
Low-dose oral corticosteroids may be necessary for weeks to months following surgery in some circumstances, such as when fungal sinusitis is the root cause of nasal polyps, to stop them from returning.
Other options include nasal saline irrigation, allergy shots, antibiotics, or surgery in some cases.
NASAL POLYPS REMOVAL
A polyp is removed with a polypectomy. Uterine and colon polypectomies are the two most popular forms of polypectomy.
Conservative treatment, which has already been addressed in the article, is typically used to treat nasal polyps. If your symptoms don’t get any better, surgery can entirely remove the polyps.
The size of the polyp will determine the type of operation. A polypectomy is an outpatient procedure that involves cutting and removing soft tissue, including the mucosa, using a small suction device called a microdebrider.
A thin, flexible endoscope with a tiny camera and tiny tools on the end can be used by your doctor to perform endoscopic sinus surgery on bigger polyps.
The polyps or other obstructions will be located and removed by your doctor using an endoscope that is inserted into your nostrils.
Additionally, your doctor might increase the sinus cavity apertures. Most of the time, this kind of surgery is performed as an outpatient treatment.
Nasal sprays and saline washes help stop polyps from coming back after surgery. In general, using nasal sprays, allergy medications, and saline washes to lessen nasal tract irritation can help prevent the growth of nasal polyps.
COMPLICATIONS OF NASAL POLYPS
The following potential issues can result from a big polyp or polyp cluster blocking airflow and the drainage of fluids from the sinuses or nasal cavity:
- Sinus infections that are persistent or frequent.
- Obstructive snoring.
- The face’s structural changes could cause double vision. The eyes may occasionally be more widely spaced apart than usual (more common in patients with cystic fibrosis).
WHEN TO SEE A DOCTOR?
Nasal polyps are often just harmless skin growths in your nasal passages, but if you have any of the following symptoms, they could become dangerous:
- Severe trouble breathing;
- Symptoms that deteriorate quickly;
- Double vision or trouble moving your eyes;
- Serious eye swelling;
- Worsening headache or headache with a high fever.
Although nasal polyps may be the source of these symptoms, they may also be a sign of another condition that necessitates prompt medical attention, such as an acute infection.
Nasal polyps are generally not hazardous, and the majority of people are unaware they have them until they start to exhibit symptoms.
However, you should always consult a doctor for treatment if symptoms persist for a long time or suddenly get worse.
OUTLOOK
Yes, a small, isolated nasal polyp may not cause any symptoms. Larger growths or crowding from small clusters of nasal polyps, on the other hand, might obstruct your nasal passageways and cause breathing difficulties, a loss of smell, and recurring sinus infections.
Nasal polyps may, in extreme situations, cause obstructive sleep apnea, which can cause exhaustion, headaches, and insomnia.
In conclusion, even if the polyps themselves are not dangerous, ignoring their presence could eventually result in issues that are not so harmless.
Aside from any potential consequences from nasal polyps, it’s always a good idea to follow up and conduct further research with a professional.