Nasal polyps

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Treatments and drugs

By Mayo Clinic staff

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Illustration of endoscopic sinus surgery, with before and after close-ups
Endoscopic sinus surgery

The treatment goals for nasal polyps are to decrease the size of polyps or eliminate polyps and to treat disorders, such as allergies, that may contribute to chronic inflammation in your nasal passages and sinuses.

Medications
Drug treatments may include:

  • Nasal corticosteroids. Your doctor is likely to prescribe a corticosteroid nasal spray to reduce inflammation. This treatment may shrink the polyps or eliminate them completely. Nasal corticosteroids include fluticasone (Flonase, Veramyst), budesonide (Rhinocort), flunisolide (Nasarel, others), triamcinolone (Nasacort AQ) and beclomethasone (Beconase AQ).
  • Other corticosteroids. If a nasal corticosteroid isn't effective, your doctor may prescribe an oral corticosteroid, such as prednisone, either alone or in combination with a nasal spray. Because oral corticosteroids can cause serious side effects, you usually take them for a brief period. Your doctor may recommend a corticosteroid injection instead or an oral corticosteroid.
  • Other medications. Your doctor may prescribe drugs to treat conditions that contribute to chronic inflammation in your sinuses or nasal passages. These may include antihistamines to treat allergies, antibiotics to treat a chronic or recurring infection, or antifungal medications to treat symptoms of fungal allergies.

Surgery
If drug treatment doesn't shrink or eliminate nasal polyps, your doctor may recommend surgery. The type of surgery depends on the size, number and location of the polyps. Surgery options for nasal polyps include:

  • Polypectomy. Small or isolated polyps can often be completely removed using a small mechanical suction device or a microdebrider - an instrument that cuts and extracts soft tissue. The procedure, called a polypectomy, is performed on an outpatient basis.
  • Endoscopic sinus surgery. You may need surgery to remove polyps and to correct problems with your sinuses that make them prone to inflammation and the development of polyps. The surgeon inserts an endoscope, a small tube with a magnifying lens or tiny camera, into your nostrils and guides it into your sinus cavities. He or she uses tiny instruments to remove polyps and other obstructions that prevent the flow of fluids from your sinuses. This surgery is usually performed as an outpatient procedure.

After surgery, you'll likely use a corticosteroid nasal spray to help prevent the recurrence of nasal polyps. Your doctor may also recommend the use of a saltwater (saline) rinse to promote healing after surgery.

References
  1. Fried M. Nasal polyps. Merck Manuals Online Medical Library: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/sec19/ch221/ch221h.html. Accessed Jan. 4, 2009.
  2. Staffel J, et al. Rhinology, nasal obstruction and sinusitis. In: Wax M, ed. Primary Care Otolaryngology. 2nd ed., e-format. Alexandria, Va.: American Academy of Otolaryngology - Head and Neck Surgery; 2004. http://www.entnet.org/EducationAndResearch/upload/Chapter-9-Rhinology-Nasal-Obstruction-and-Sinusitis.pdf. Accessed Jan. 7, 2009.
  3. Pawliczak R, et al. Pathogenesis of nasal polyps: An update. Current Allergy and Asthma Reports. 2005;5:463-471.
  4. Fried M. Nasal polyps. Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec08/ch091/ch091d.html. Accessed Jan. 4, 2009.
  5. Sinusitis. American Academy of Otolaryngology - Head and Neck Surgery. http://www.entnet.org/HealthInformation/Sinusitis.cfm. Accessed Jan. 10, 2009.
  6. Pillsbury HC III, et al. Nose and sinuses. Merck Manuals Online Medical Library: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/print/sec19/ch217/ch217c.html. Accessed Jan. 7, 2009.
  7. Fungal sinusitis. American Academy of Otolaryngology - Head and Neck Surgery. http://www.entnet.org/HealthInformation/Fungal-Sinusitis.cfm. Accessed Jan. 10, 2009.
  8. Haddad J Jr. Nasal polyps. In: Kliegman R, et al, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia: Saunders/Elsevier Inc.; 2007. http://www.mdconsult.com/das/book/body/116189915-2/0/1608/891.html. Accessed Jan. 10, 2009.
  9. Rosenfeld RM. Clinical practice guideline on adult sinusitis. Otolaryngology - Head and Neck Surgery. 2007;137:365-377.
  10. Tips to remember: What is allergy testing? American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/patients/publicedmat/tips/whatisallergytesting.stm. Accessed Jan. 10, 2009.
  11. Scadding GK. Comparison of medical and surgical treatment of nasal polyposis. Current Allergy and Asthma Reports. 2002;2:494-499.
  12. Sinus surgery. American Academy of Otolaryngology - Head and Neck Surgery. http://www.entnet.org/HealthInformation/SinusSurgery.cfm. Accessed Jan. 10, 2009.
  13. Tips for sinus sufferers. American Academy of Otolaryngology - Head and Neck Surgery. http://www.entnet.org/HealthInformation/tipsSinusSufferers.cfm. Accessed Jan. 10, 2009.

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Feb. 20, 2009

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