A Complete Guide to Understanding and Treating Nasal Polyps

Nasal polyps affect millions of people worldwide, yet many remain unaware of what causes them or how they can be treated. These benign growths form as a result of chronic inflammation in the nasal passages and sinuses, often linked to conditions like asthma, recurring infections, allergies, or certain immune disorders. While small polyps may not cause noticeable symptoms, larger ones can lead to persistent congestion, reduced sense of smell, facial pressure, and even snoring. Fortunately, modern medicine offers several effective treatment approaches ranging from medications to surgical interventions.

What Are the Main Treatment Options for Nasal Polyps?

Treating nasal polyps typically begins with conservative medical management. Corticosteroid nasal sprays are often the first line of defense, helping to reduce inflammation and shrink polyps over time. For more severe cases, oral corticosteroids may be prescribed for short-term use to rapidly decrease polyp size and relieve symptoms. Antihistamines and decongestants can provide additional relief, especially when allergies contribute to the inflammation. Saline nasal irrigation is another helpful tool that flushes out irritants and keeps nasal passages moist. When medical treatments fail to provide adequate relief or polyps recur frequently, more advanced interventions become necessary.

How Do Biologics Work for Nasal Polyps?

Biologics represent a significant advancement in treating chronic rhinosinusitis with nasal polyps, particularly for patients who do not respond well to conventional therapies. These targeted medications work by blocking specific proteins in the immune system that drive inflammation. Dupilumab, for example, is a biologic approved for treating nasal polyps that targets interleukin-4 and interleukin-13, two key inflammatory pathways. Administered through regular injections, biologics can significantly reduce polyp size, improve breathing, and restore the sense of smell in many patients. While biologics are generally well-tolerated, they require ongoing administration and monitoring by a healthcare professional. The decision to use biologics typically depends on polyp severity, symptom impact on quality of life, and response to previous treatments.

What Is FESS and When Is It Recommended for Nasal Polyps?

Functional Endoscopic Sinus Surgery, commonly known as FESS, is a minimally invasive surgical procedure used to remove nasal polyps and open blocked sinus passages. During FESS, an otolaryngologist uses a thin, flexible endoscope equipped with a camera to visualize the nasal cavity and sinuses. Small surgical instruments are then inserted to carefully remove polyps and any diseased tissue, improving drainage and airflow. The procedure is typically performed under general anesthesia and most patients can return home the same day. FESS is generally recommended when medications fail to control symptoms, polyps are large or causing complications, or when there are structural issues contributing to chronic sinusitis. Recovery usually takes a few weeks, during which patients use saline rinses and may continue nasal steroid sprays to prevent recurrence. While FESS has a high success rate, polyps can regrow in some cases, making ongoing medical management important even after surgery.

What Does Current Research Say About Nasal Polyps?

Nasal polyps research continues to evolve, with scientists working to better understand the underlying mechanisms that cause these growths and develop more effective treatments. Recent studies have focused on the role of the immune system, particularly type 2 inflammation, in polyp formation. Researchers are investigating new biologic therapies that target different inflammatory pathways, potentially offering more treatment options for patients with difficult-to-manage polyps. Genetic studies are also exploring whether certain individuals have a predisposition to developing nasal polyps. Additionally, research into the nasal microbiome examines how bacterial communities in the nose and sinuses might influence polyp development and recurrence. Clinical trials are ongoing to evaluate combination therapies that use multiple approaches simultaneously, such as surgery followed by biologics, to achieve better long-term outcomes. Understanding the connection between nasal polyps and other conditions like aspirin sensitivity and eosinophilic diseases remains an active area of investigation.

How Can Lifestyle Changes Support Treatment?

While medical and surgical treatments form the foundation of nasal polyp management, certain lifestyle modifications can help reduce symptoms and potentially slow polyp growth. Avoiding environmental irritants such as tobacco smoke, strong chemical fumes, and air pollution can minimize nasal inflammation. Managing allergies through allergen avoidance and appropriate medications helps reduce one of the key triggers for polyp formation. Maintaining good nasal hygiene with regular saline rinses keeps passages clear and removes inflammatory particles. Staying well-hydrated helps thin mucus, making it easier to drain and reducing congestion. For those with aspirin sensitivity, avoiding aspirin and related nonsteroidal anti-inflammatory drugs is crucial, as these can worsen symptoms. Using a humidifier in dry environments can prevent nasal passages from becoming irritated. These supportive measures work best when combined with prescribed medical treatments and regular follow-up with healthcare providers.

What Should You Expect From Long-Term Management?

Managing nasal polyps is often a long-term endeavor requiring ongoing attention and treatment adjustments. Even after successful initial treatment, polyps have a tendency to recur, making continuous management essential. Regular follow-up appointments allow healthcare providers to monitor polyp regrowth and adjust medications as needed. Many patients benefit from maintenance therapy with nasal corticosteroid sprays to keep inflammation under control. Those who have undergone surgery may need periodic endoscopic examinations to detect early signs of recurrence. The introduction of biologics has changed the landscape for patients with severe, recurrent polyps, offering a way to maintain remission without repeated surgeries. Open communication with your healthcare team about symptom changes, medication side effects, and quality of life concerns ensures that treatment remains effective and tailored to your individual needs. With proper management, most people with nasal polyps can achieve significant symptom relief and improved breathing.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.