Disease Information for Nasal polyps/sinus polyps

Nasal polyps are pale, edematous, mucosally covered masses commonly seen in patients with allergic rhinitis, but compelling evidence argues against a purely allergic pathogenesis; They may result in chronic nasal obstruction and a diminished sense of smell; In patients with nasal polyps and a history of asthma, aspirin should be avoided as it may precipitate a severe episode of bronchospasm; The presence of polyps in children should suggest the possibility of cystic fibrosis; Initial treatment with topical nasal steroids (see Allergic Rhinitis section for specific drugs) for 1–3 months is usually successful for small polyps and may reduce the need for operation; A short course of oral corticosteroids (eg, prednisone, 6-day course using twenty-one 5-mg tablets: 30 mg on day 1 and tapering by 5 mg each day) may also be of benefit; When medical management is unsuccessful, polyps should be removed surgically; In healthy persons, this is a minor outpatient procedure; In recurrent cases or when surgery itself is associated with increased risk (such as in asthmatics), a more complete procedure, such as ethmoidectomy, may be advisable; In recurrent polyposis, it may be necessary to remove polyps from the ethmoid, sphenoid, and maxillary sinuses to provide longer-lasting relief; [Current medical DX RX 2005]

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