Nasal Polyps - Causes, Symptoms and Treatment

What is this condition?

Nasal polyps are benign and swollen growths that appear in the nose. Numerous polyps may occur in both sides of the nose. They may become large and numerous enough to cause nasal distention and enlargement of the bony framework, possibly blocking the airway. They are more common in adults than in children and tend to recur.

What causes it?

Nasal polyps usually result from the continuous pressure resulting from a chronic allergy that causes prolonged mucous membrane swelling in the nose and sinuses. Other predisposing factors include chronic sinus infection, chronic rhinitis, and recurrent nasal infections.

What are symptoms for Nasal Polyps?

Nasal blockage is the primary symptom of nasal polyps. The block­age causes loss of the sense of smell, a sensation of fullness in the face, nasal discharge, headache, and shortness of breath. Other symptoms usually mimic those of allergic rhinitis.

How is it diagnosed?

The doctor will use X-rays of the sinuses and nasal passages and will examine the nose with a nasal speculum to help diagnose nasal polyps.

How is it treated?

The doctor will prescribe steroid drugs to be administered either by direct injection into the polyps or by local spray to temporarily shrink the polyps. The doctor may also treat the underlying cause, using antihistamines to control allergy and antibiotics if infection is present. Local application of an astringent shrinks swollen tissue.

Unfortunately, medical treatment alone is rarely effective in alleviating nasal polyps. Consequently, the doctor will surgically remove the polyps, usually using local anesthesia. Laser surgery is being used more frequently for polyp removal.

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If part of the mucous membrane that lines the nose becomes distended and protrudes into the nasal cavity, the growth that it forms is known as a nasal polyp. Polyps are caused by overproduction of fluid in the cells of the membrane. This can be caused by a condition such as allergic rhinitis . These polyps are harmless, but a big one or several little ones can obstruct your nasal passages, make breathing difficult, and impair your sense of smell. If the opening between the nasal cavity and one of the sinuses is blocked by a polyp, you may have headaches or pain in the muscles of your face.

What should be done?

If your nose is gradually becoming blocked, you may have nasal polyps. You may be able to see them in a mirror, by shining a light up your nostrils. They look like pearly gray lumps. However, polyps are often at the back of the nose, where you can only see them with a special instrument. If you suspect that you have nasal polyps, you should consult your physician. The only way to treat nasal polyps is to remove them. If the diagnosis is confirmed, your doctor may refer you to a specialist for surgery. This minor operation is usually done under local anesthetic. Sometimes both the polyps and the lining of the sinuses where they originate must be removed. In these cases, more extensive surgery that is performed under a general anesthetic is required.

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The sinuses are air spaces in the bones behind your nose. Sinusitis is an inflammation of the mucous membranes of the sinuses. It is caused by bacterial or viral infection. The frontal sinuses, which are in the forehead just above the eyes, and the maxillary sinuses, which are in the cheek-bones, are the ones that are most likely to be affected.The organisms that cause sinusitis spread to the sinuses from the nose. This occurs easily because the mucous membranes of the main nasal cavity extend into and line the sinuses. Sinusitis usually occurs after a common cold, which is a viral infection, is complicated by the occurrence of a secondary bacterial infection

What are the Symptoms?

After the first few days of a cold, when you would expect it to get better, the blockage in your nose may worsen and the greenish discharge may increase. Later, because the passages between the nose and the sinuses also become blocked, the discharge may stop. Your nose then becomes more stuffed up than ever. You have to breathe through your mouth, your speech becomes nasal, and you feel generally ill. If the frontal sinuses are affected, you may have a headache over one or both eyes. It is most painful when you wake up in the morning, or when you bend your head down and forward. The under surface of your forehead just above the eyes may feel tender.

If the maxillary sinuses are affected, one or both cheeks may hurt. You may feel as if you have a toothache in your upper jaw. Occasionally, sinusitis may follow dental treatment, because infection can spread from the roots of your tooth into one of your sinuses .

Sinusitis is common, but susceptibility varies. Some people never get it, while others get it every time they have a bad cold. Others may get sinusitis by jumping into water feet first without holding their noses. Damage to your nasal bones, or even a foreign body caught in your nostril, may make you more susceptible to infection and, thus, bring on an attack. A deformity of the nose, such as a deviated septum , may increase your susceptibility to sinusitis by obstructing the nasal airways.

What are the Risks?

The risks of sinusitis are minimal if it is treated with antibiotics. Before the availability of antibiotics, the infection sometimes spread through the mucous membrane of the sinuses into the bones and even to the brain. Such serious complications of sinusitis almost never happen today.

What should be done?

Try the self-help measures recommended below. If the symptoms persist after three or four days, consult your physician, who may confirm the diagnosis of sinusitis by examining X-rays of your sinuses. The physician may also gently press the floor of the sinuses from inside your nose and mouth.

What is the Treatment?

Self-help: Stay indoors, in a room with an even temperature. Add moisture to the air with a vaporizer or humidifier. Blow your nose gently with tissues. To relieve the pain, inhale steam from a basin of hot water, or the spout of a kettle, but be careful not to burn yourself; steam is very hot.

Professional help: Your physician may prescribe a broad spectrum antibiotic and also suggest that you use decongestant tablets, nose drops, or a nasal spray. Decongestants shrink the swollen mucous membrane, which widens the airways, but for sinusitis they should be used only as prescribed by a doctor. If they are used incorrectly, decongestants can do more harm than good.

Further treatment should be unnecessary, but if the sinusitis persists, your physician may advise a minor operation under local anesthetic. In this procedure, the physician or surgeon pierces a bone between the nose and the sinuses to open an extra passageway, and washes the sinuses out with sterile water. This procedure relieves the obstruction. Material that is removed from the sinus can be analyzed to identify the cause of the infection and determine the best way to combat it. You may discover that you will need additional minor surgery to improve drainage if the infection becomes chronic, but this complication rarely happens.

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The disease we call the common cold is really a group of minor illnesses that can be caused by anyone of almost 200 different viruses. Usually a common, or head, cold is confined to the nose and throat, but the same viruses can also infect the larynx and the lungs . These viral infections sometimes are followed by more serious bacterial infections of the throat, lungs, or ears.All of us get colds. Most people have their first cold during their first year of life. Most children are extremely susceptible to nasal viral infection between the ages of one and three. Then they gradually become immune to many of the viruses that are common in their environment. The frequency of colds increases again during early school years, because the school environment contains new types of viruses. Most people acquire more immunity as they grow older, and catch fewer and less severe colds.

What are the Symptoms?

To some extent the symptoms depend on. In you If you have recurrent attacks of bronchitis or frequent case, an antibiotic may be useful, since it will give you some protection against the bacteria-caused complications to which you are prone. Thus, in your case, the benefits of the drug will probably outweigh the possible drawbacks. Consult your physician who can explain your individual situation and recommend appropriate treatment.

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What is this Condition?

A nosebleed may be a primary disorder or may result from another condition. In children, bleeding generally originates in the anterior nasal septum and tends to be mild. In adults, it s most likely to originate in the posterior septum and can be severe. Nosebleeds are twice as common in children as in adults.

What Causes it?

A nosebleed usually occurs after an injury, such as a blow to the nose. nose picking, or insertion of a foreign body into the nose. Less commonly, it occurs as a complication of nasal polyps or acute or chronic infections, such as sinusitis or rhinitis, which cause congestion and eventual bleeding of the capillary blood vessels. It may also result from inhalation of chemicals that irritate the nasal mucosa.

Factors that predispose a person to nosebleeds include use of blood­thinning drugs (called anticoagulants), high blood pressure, chronic aspirin use, high altitudes and dry climates, sclerotic vessel disease. Hodgkin’s disease, certain cancers, scurvy, vitamin K deficiency, rheumatic fever, blood disorders (hemophilia, purpura, leukemia, and anemias), and a bleeding disorder called hemorrhagic telangiectasia.

What are its Symptoms?

Blood oozing from the nostrils usually originates in the anterior nose and is bright red. Blood from the back of the throat originates in the posterior area and may be dark or bright red (and is often mistaken for hemoptysis, expectorated blood that is usually a sign of a respiratory disease). A nosebleed generally occurs only in one nostril, except when it’s caused by a blood disorder or severe injury. In a severe nosebleed, blood may seep behind the nasal septum and may appear in the middle ear and in the corners of the eyes.

Associated symptoms depend on the severity of bleeding. Moderate blood loss may cause light-headedness, dizziness, and slight respiratory difficulty. Severe bleeding causes low blood pressure, rapid and bounding pulse, difficulty breathing, and pallor. Bleeding is considered severe if it lasts longer than 10 minutes after pressure is applied and may cause blood loss as great as 1 liter per hour in adults.

How is it Diagnosed?

Although simple observation confirms a nosebleed, inspection with a bright light and nasal speculum is necessary to locate the site of bleeding. The doctor may also order blood tests to evaluate blood count and clotting ability.

When making a diagnosis, the doctor must check for an underlying disorder that may cause nosebleed, especially disseminated intra­vascular coagulation (a condition marked by bleeding at multiple sites within the body) and rheumatic fever. Bruises or concomitant bleeding elsewhere probably indicates a blood disorder.

How is it Treated?

For anterior bleeding, the doctor will recommend applying a cotton ball saturated with epinephrine to the bleeding site and applying external pressure to the nose. The doctor may then cauterize the bleeding site with electrocautery or silver nitrate stick. If these measures don’t control the bleeding, petrolatum gauze nasal packing may be inserted.

For posterior bleeding, the doctor will insert gauze packing through the nose or postnasal packing through the mouth, depending on the bleeding site. (Gauze packing generally remains in place for 24 to 48 hours; postnasal packing, for 3 to 5 days.) An alternative method, the nasal balloon catheter, also controls bleeding effectively. The doctor may also prescribe antibiotics if packing must remain in place for longer than 24 hours.

If local measures fail to control bleeding, additional treatment may include supplemental vitamin K. A person with severe bleeding may require blood transfusions and surgery to close off a bleeding artery.

What can a Person with Nosebleeds do?

• To control a nosebleed, sit upright. Then press the soft portion of. the nostrils against the septum continuously for 5 to 10 minutes. Apply an ice collar or cold, wet compresses to the nose. If bleeding continues after 10 minutes of pressure, notify the doctor. Breathe through your mouth. Don’t swallow blood, talk, or blow your nose.

• Know that a nosebleed usually looks worse than it is.

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