Nose and Sinus
What is the treatment of nasal polyps?
Association Asthma, Allergy and Nasal Polyps
Association of polyps and Obstructive Sleep Apnea – Snoring
Why do we have Noses?
To provide the lungs with good quality air: The nose’s main function is to humidify, filter and warm-up inspired air.
To Smell: the nose is our fire-alarm.
The nose has also an important Immune function: Many bacteria viruses etc.. are eliminated in the nose
We think also that the nose is involved in the protection against blood clotting during the night-time.
What are the Sinuses?
Sinuses are air pockets that are located within the bones of the skull and face and are connected to your nasal passages by small tubes or channels, the osteomeatal channels. These channels permit air to flow from the nose into the sinuses and allow drainage of mucous from each sinus into the nose
The air within our sinuses exchanges constantly with air flowing through the nose.
The osteomeatal channel, or the connection from the sinus to the nose, can also vary substantially in its length or width. This difference can impact greatly on the ability of this channel to function properly.
We have 4 major sinuses on each side. Frontal, Ethmoid, Maxillary and Sphenoid. Blockage of these channels, partial or complete, by either structural conditions or swollen membranes is the cause of Rhinosinusitis. ?
What are Nasal Polyps?
Nasal polyps are soft, noncancerous (benign) growths that develop on the lining of your nose or sinuses. The polyps are generally soft and pearl colored, with a consistency like jelly.
Small nasal polyps usually cause few problems, but larger ones can affect your breathing and diminish your sense of smell. Sometimes they may cause dull headaches or snoring, and in rare cases, massive nasal polyps can alter the shape of your face.
Nasal polyps result from chronic inflammation in the lining of your nose or sinuses, but just what triggers the inflammation isn’t always clear. Inflammation is often, but not always caused by ALLERGY. Not only inhaled allergen can cause nasal polyps to grow, but also some food allergies could cause their growth.
What are the symptoms of nasal polyps?
- Nasal congestion
- A runny nose
- Persistent stuffiness
- Chronic sinus infections
- Loss or diminishment of your sense of smell
- Dull headaches
- Snoring
What are the complications of nasal polyposis?
A single, small nasal polyp rarely causes complications, but a large polyp or many smaller polyps (polyposis) may lead to the following:
Acute or chronic sinus infections.
Obstructive sleep apnea / Snoring – a potentially serious condition in which you stop and start breathing a number of times during sleep.
Altered facial structure leading to double vision or unusually wide-set eyes. This complication is rare and is most likely to occur in people with cystic fibrosis.
What is the treatment of nasal polyps?
The main treatment of nasal polyps is nasal steroids in the form of spray or drops. This treatment is however limited and might be ineffective if you have a nasal septal deviation (a bent partition of the nose), or if the polyps are within the nasal sinuses.
Other medications for nasal polyps include:
- Oral corticosteroids. Sometimes your doctor may prescribe an oral corticosteroid, either alone or in combination with a nasal spray. Because oral steroids can cause serious side effects, you usually take them for a brief period – often no longer than a few weeks.
- Medications to control allergies or infection. In addition to treating your polyps, your doctor may prescribe medications to control allergies or infection. Antihistamines, for instance, counteract histamine, an inflammatory substance released when your immune system encounters an allergen. If you have hay fever or other allergies, antihistamines may help relieve your congestion, although they won’t eliminate polyps. In addition, your doctor may prescribe antibiotics for an acute sinus infection.
- Antifungal medications. Researchers have discovered that some cases of chronic sinusitis may be caused by an unusual immune system response to environmental fungus. For that reason, antifungal medications may be useful, though surgical removal of fungal debris also may be necessary.
Surgery
Treatment for nasal polyps may also involve surgery. When medications aren’t effective, your doctor may recommend removing your polyps. This is often the only option for people with cystic fibrosis who usually don’t respond to steroids. The type of operation depends on the size, number and location of the polyps. Options for nasal polyps surgery 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. After polypectomy, you’ll be treated for any underlying inflammation, usually with corticosteroid nasal sprays and sometimes with antibiotics or oral steroids. Even so, polyps frequently return, and you may need additional surgery.
- Endoscopic sinus surgery. This is a more extensive procedure that not only removes polyps, but also opens the part of the sinus cavity where polyps usually form. If your sinuses are very blocked or inflamed, your doctor may open even more of your sinus cavity. In both cases, your surgeon uses a thin, rigid tube and a camera called a video endoscope. Because endoscopic surgery requires small incisions, you generally heal more quickly and with less discomfort than with other types of surgery. Still, full recovery may take several weeks, and polyps often return.
Association Asthma, Allergy and Nasal Polyps
In a recent study that we carried out at Basildon Hospital we discovered that nearly every asthmatic patient has nasal polyps. Many of those patients don’t even know that they have these polyps.
Conversely, many patients presenting with nasal polyps, suffer from asthma.Most of patients with asthma will see a great improvement in their symptoms after treatment of the nasal polyps.
It is very important for patients suffering from either asthma, nasal polyps or both to have comprehensive allergy testings.Curing an underlying allergy, by means of SLIT (sub-lingual immuno therapy) for example, will often cure at the same time asthma and/or nasal polyps.
Association of Polyps and Obstructive Sleep Apnea – Snoring
Patients with nasal polyps suffer often from snoring.
They also often suffer from a serious condition: Obstructive Sleep Apnea Syndrome (OSAS).Treating nasal polyps is indispensable to treat snoring and OSAS.