Ashleigh Halderman, M.D. Answers Questions On: Nasal Polyps

Nasal polyps are swellings of nasal and sinus tissue. They often occur on both sides of the nose and sinuses. When you see them through the scope, they look like peeled grapes.

They are not precancerous, unlike some colon polyps. However, cancerous and noncancerous nasal tumors can have a similar polyp-like appearance. If a patient comes in and has polyps on only one side of the nose, I consider a tumor as a possibility.

People with nasal polyps usually have a lot of nasal congestion and blockage. Onset can be gradual over several years or over a few months. They also suffer from nasal drainage and post-nasal drip. They may also experience facial pressure.

Another bothersome symptom is decreased sense of smell and taste. When you can’t smell, the only tastes you can get from the tongue are “bitter” and “sweet.” This makes mealtimes no longer pleasurable, and because eating is such a crucial part of our social culture, it’s a major issue for patients with nasal polyps.

Anyone with drainage and symptoms of congestion and difficulty breathing through the nose should come see us. Sometimes polyps can be seen with the naked eye by inspecting inside the nose while looking in the mirror – or polyps may even protrude from the nostrils.

To diagnose polyps, we’ll look in the nose with an endoscope and possibly do a CT scan to better visualize the sinuses. Once the diagnosis is confirmed, we’ll often start treatment by prescribing steroids. These can work like magic for some people and not at all for others.

If a patient doesn’t have a great response to the steroids, I’ll offer surgical treatment to take out the polyps and open up the sinuses. After surgery, patients rinse with a saline solution combined with liquid steroids. This method can make the steroids much more effective because they are directly exposed to the tissue.

Nasal polyps are a chronic condition, meaning they can’t be prevented or cured, but everyone responds differently to treatment.

Some patients do fine with medical treatment – such as steroid medications – and never need surgery. Others have surgery and the polyps return in six months or 10 years.

This is an active area of research. We are trying to identify the differences in polyp patients that make their responses to treatment and recurrences so variable. The goal is to eventually find effective treatments for all patients.