Subscribe
Nasal polyps
How to deal with nasal polyps and enlarged turbinates?
Nasal polyps and hypertrophic turbinates require surgical treatment because both are manifestations of chronic inflammation in rhinitis. Medical treatment alone is not very effective in these cases. Nasal polyps and hypertrophic turbinates mainly cause poor nasal ventilation, and over time, can also affect the drainage of the sinuses. Therefore, in patients with significantly enlarged nasal polyps, who often also suffer from chronic sinusitis, treatment involves the endoscopic removal of nasal polyps and partial resection of the inferior turbinate, along with the opening of the sinus passages. This is a systematic and comprehensive treatment approach. After surgery, it is crucial to follow a prescribed medication regimen, as this ensures the effectiveness of the surgery. If surgery is performed without subsequent medication, the results may not be very good. Additionally, regular postoperative check-ups and cleanings are essential to maintain the effectiveness of the surgery and to prevent long-term recurrence. Many patients who cease medication and do not return for follow-up cleanings after surgery are likely to experience a quick recurrence.
Do nasal polyps definitely have to be removed?
Nasal polyps are benign glandular tissues that occur in the nasal cavity. The presence of nasal polyps can block the nasal passage, leading to secondary infections, and as nasal polyps gradually increase in size, they can damage the local tissue structure. Therefore, once nasal polyps appear, they are primarily removed through surgery, making surgical removal necessary. However, in the early stages of nasal polyps, when they have just developed and are still small, they can be treated with medications such as methylprednisolone or prednisone. These drugs are mainly corticosteroids and can cause the polyps to gradually shrink and disappear in a minority of patients, a process referred to as chemical resection through medication. Nonetheless, the chance of detecting nasal polyps in their early stages is very small, and they are often only discovered when they have grown large enough to obstruct the nasal passage and affect breathing, meaning that they typically require surgical removal after they are found.
What should I do if nasal polyps are removed but grow back?
Nasal polyps are a common condition in otolaryngology and are benign neoplasms in the nasal cavity. After nasal polyp surgery, there is a possibility of recurrence, and the likelihood of recurrence is relatively high compared to other diseases. Currently, we surgically remove nasal polyps through functional endoscopic surgery, followed by regular post-operative outpatient follow-ups to clean the nasal cavity. Since then, the recurrence rate after this surgery has been relatively low. However, if the nasal polyps recur, we must perform surgery again to remove them, as enlarged nasal polyps can block the nasal cavity and damage the surrounding tissue structures, necessitating another surgical intervention, with no other special methods available.
The difference between nasal polyps and adenoids
There are fundamental differences between nasal polyps and adenoids. Nasal polyps are polypoid tissue proliferations located in the nasal cavity and sinus cavities, resembling a peeled lychee. In contrast, adenoids are located in the nasopharynx and are a normal anatomical structure of the human body, whereas nasal polyps are a new benign tumor-like growth. Furthermore, nasal polyps require surgical removal, primarily through functional endoscopic sinus surgery. Adenoids generally do not require surgical treatment unless they are enlarged, causing issues such as snoring and sleep apnea, in which case surgery might be considered.
How to check for nasal polyps
Nasal polyps are benign space-occupying lesions that occur in the nasal cavity and sinus cavities. There are several aspects to the examination of nasal polyps: Firstly, an anterior rhinoscopy examination can be performed. If the nasal polyps are large, or even protruding outside the nasal cavity, they can be directly seen. Anterior rhinoscopy enlarges the nasal cavity, allowing visualization of the middle nasal meatus and other tissues inside the nasal cavity. Secondly, a nasal endoscopy can be utilized. Nasal endoscopy is particularly effective for viewing polyps located deeper within, or at the back of the nasal passages, providing very clear visibility. Other examinations, such as electronic rhinoendoscopy, follow the same procedure. The third examination involves a sinus CT scan, which is helpful for identifying the origin of the nasal polyps, as well as the location, range, and extent of obstruction caused by the polyps. Another examination is the pathological examination after nasal polyp surgery, which aids in determining the origin and risk associated with the nasal polyps, as well as assisting in subsequent treatments.
Can nasal polyps be felt by touch?
Nasal polyps are benign neoplasms that occur in our nasal cavity. Clinically, nasal polyps in their early stages are primarily located in the middle nasal passage. As the nasal polyps enlarge, they can also be found in the middle nasal passage, and severe ones might even protrude from our anterior nostrils onto our face. Thus, for larger nasal polyps, we can physically feel them; they feel very soft and not very elastic. However, they are somewhat resilient and can move significantly because most nasal polyps are pedunculated within our nasal cavity. Additionally, there is often a lot of nasal mucus.
How is nasal polyps treated?
Nasal polyps are a common clinical condition, prevalent in the nasal and sinus cavities as benign space-occupying lesions. Clinically, these polyps appear as translucent, lychee-like neoplasms. The primary clinical treatment for nasal polyps is surgical, typically performed with an endoscope to remove the polyps, mainly using a powered system. After nasal polyp surgery, the treatment is not completely finished; regular outpatient follow-ups are necessary to infiltrate the nasal and sinus cavities and remove some of the swollen mucosal tissue, thus preventing the recurrence of nasal polyps.
Is minimally invasive surgery for nasal polyps painful?
We often talk about the minimally invasive surgery for nasal polyps, which is the most common procedure of endoscopic nasal polyp removal that we use today. This type of surgery does not only remove the nasal polyps, but also the root of the polyps and even opens up the sinuses. This is crucial for eliminating the cause of the nasal polyps and is very important for preventing their recurrence. Although it is a minimally invasive surgery, it can still be quite painful. After the surgery, both nostrils need to be packed. If the packing material is absorbable, such as Nasopore, the discomfort might be less because after the surgery, one just needs to wait for the packing to gradually dissolve into a mucus-like substance and get expelled. However, if expandable sponges or even gauze strips are used, these materials need to be removed after several days. Removing these materials can cause significant pain for the patient. During the period of packing, the patient can also experience a lot of discomforts such as headaches, dry throat, discomfort in the eyes, tearing, and even some might feel foggy in their ears and uncomfortable while eating and drinking, along with other painful symptoms. Additionally, after the minimally invasive surgery for nasal polyps, regular follow-up cleanings are necessary. The purpose of these follow-up cleanings is to timely clear out any blood clots or secretions from the nasal cavity and sinuses, aiding the recovery of the mucous membranes in these areas and also preventing the short-term recurrence of the nasal polyps, which is a very important part of ensuring the effectiveness of the surgery. Thus, these procedures can induce a certain amount of fear and pain for the patients, but before performing these surgeries and examinations, doctors generally engage in thorough discussions and provide comfort to the patients, advising them not to be too nervous. The actual discomfort is temporary and will pass after enduring it for just a few days post-surgery.
Do you need to be hospitalized for nasal polyp surgery?
The current nasal polyp surgery requires a general anesthesia and endoscopic nasal polypectomy. Since the surgery is performed under general anesthesia, more thorough preparations are made for hospitalized patients. The surgery demands high standards, thus preoperative blood tests and related cardiopulmonary function tests are necessary, requiring hospitalization. Additionally, after the surgery, nasal packing is needed to monitor the patient's recovery and to clean the nasal cavities and sinuses. Therefore, hospitalization is needed for this type of treatment, which generally lasts from 5 to 7 days from admission to discharge.