Nasal Polyps - Diagnosis, Treatment and Prevention of Recurrence
Nasal Polyps are soft, fleshy growths that occur in the nasal passages and sinuses of a small percentage of the population (1-4%)* medicine. See Figure 1. When present, polyps can cause nasal obstruction, diminished sense of smell and impaired drainage and ventilation of the sinuses resulting in stagnant mucous residing in those sinuses. Most nasal and sinus polyps are benign (not cancerous) and occur in response to inflammation in the nose and sinuses. Polyps are associated with many different medical conditions including Allergic Rhinitis, Chronic Sinusitis with Nasal Polyps, Cystic Fibrosis, Allergic Fungal Sinusitis, Samter’s Triad (Aspirin Exacerbated Respiratory Disease), Eosinophilic Mucin Rhinosinusitis and Asthma (some cases, not all cases of asthma, are associated with nasal polyps). Treatment of nasal polyps has traditionally included medications designed to decrease the inflammation of the nasal and sinus mucous membranes in hopes of shrinking the polyps.
When medical therapy fails to effectively treat the polyps, surgery is often recommended to clear the nasal passages and sinuses of those obstructing polyps. For most patients in our practice surgery results in improved nasal breathing and sense of smell. It often decreases frequency of sinusitis as well. Most often, nasal polyp removal surgery is accomplished through a technique called Endoscopic Sinus Surgery. This is usually performed as outpatient surgery (the patient goes home the same day) with one week of recovery time where vigorous physical activity should be avoided. Technological advancements in instrumentation and products used during surgery now allow this to be done without using obstructive packing in the nose or severe pain (most patients go to the recovery room after surgery breathing comfortably through the nose). One challenge in nasal polyp treatment is prevention of recurrence of the polyps. While surgery helps remove the polyps and restore nasal breathing and sense of smell, it does not change the patient’s unique immune system or the environment the patient lives in. This means the patient is returned to the same environment (which includes air quality, diet and lifestyle) and is subject to recurrence of the causative nasal inflammation with regrowth of the polyps.
At the Arizona Sinus Center, our nasal polyp experts are focused on accurate diagnosis and treatment of nasal polyposis and closely follow patient symptom outcomes long term. We are also intensely focused on prevention of recurrence of nasal polyps. Historically, even with advanced medical care here in the U.S., patients and physicians have had poor success in reliably preventing nasal polyp recurrence. Our physicians are not satisfied in the treatment process if nasal polyps return after successful treatment. Our physicians certainly cannot guarantee that polyps will not recur but they educate the patient and make every effort to keep the nose and sinuses polyp free. They believe in root cause analysis to try to understand what the triggers are for polyp formation in each patient. Triggers or causes can include genetic predisposition, allergens, air pollution, dust, chemical exposures, certain foods, bacterial toxins and altered microbiome (the population of microorganisms found on our mucous membrane surfaces). Emerging research has shed light on some of the dietary triggers for nasal inflammation which may lead to polyposis. In some patients, taking a "functional medicine” approach (ie. what did the patient do, ingest or breathe to cause this) to prevention of polyps has helped many patients decrease the likelihood of recurrence and keep the nasal and sinus mucous membranes healthy. This involves tremendous commitment from the patient to maintain a wellness including a healthy diet, dedicated exercise regimen, adherence to medical treatment protocols and commitment to adequate sleep for nightly repair and restoration. On occasion a functional medicine consultation may be necessary to help with our nasal and sinus treatment plan.
*McClay, JE. Nasal Polyps. Emedicine http://emedicine.medscape.com/article/994274
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PolypVac - In Office Removal of Nose Polyps
Up to 12 million people in the US alone have nasal polyps. Nasal polyps are relatively common growths in the lining of the nose. They can block nasal passages, preventing normal sinus drainage and leading to difficulties breathing, smelling, and sleeping.
The PolypVac is an FDA-cleared, safe, clinically proven technology that allows doctors to remove nasal polyps during either a routine visit or a conveniently scheduled office appointment, without general anesthesia.