Nasal polyps

Published by Bupa’s Health Information Team, July 2011.

This factsheet is for people who have nasal polyps, or who would like to know more about them.

Nasal polyps are fleshy swellings of the lining of the nose. Common symptoms include a blocked and runny nose. Nasal polyps can be treated with nasal drops or spray, although some people need surgery to remove them.

About nasal polyps

Nasal polyps are shaped like teardrops. They develop singly or in clusters around the openings to your sinuses (air-filled spaces behind the bones of your face that open up into your nose). Nasal polyps often develop in the sinuses behind the bridge of your nose – called the ethmoid sinuses. They usually grow on both sides of your nose and can completely block your nasal passages.

Nasal polyps can happen at any age but are most common in men over 40. Children between two and 10 years old don’t usually get them.

Symptoms of nasal polyps

If you have nasal polyps, your symptoms may include:

•  blocked nose
•  runny nose
•  sneezing
•  mucus draining down the back of your nose into your throat (postnasal drip)
•  loss of smell and taste
• change in voice

You may get headaches and pain in your face around your eyes and cheeks. If the nasal polyps block your sinuses, they can cause sinus infection.

Causes of nasal polyps

The exact cause of nasal polyps isn’t known. They are linked to inflammation of the lining of your nose, so they may arise if you have had an ongoing sinus infection. They are also linked to a type of allergy to fungus in the environment, called allergic fungal sinusitis.

If you develop asthma as an adult, you’re more likely to develop nasal polyps. You’re also more likely to get nasal polyps if you’re intolerant to aspirin. 

Diagnosis of nasal polyps

If you think you have nasal polyps, visit your GP for advice. He or she will ask about your symptoms and examine you. Your GP may also ask you about your medical history.

If only one nostril is affected, your GP will refer you to an ear, nose and throat (ENT) specialist. You may need a biopsy of the polyp to make sure it's not a cancer.

Treatment of nasal polyps

If your nasal polyps are small, your GP may prescribe you corticosteroid nasal drops. This can help to reduce the size of the polyps. After this, your GP may prescribe a corticosteroid nasal spray to make sure the polyps don't grow back. Nasal polyps shrink in eight out of 10 people who use nasal drops or spray. It can take around six weeks before you notice any improvement in your symptoms.

If you have larger polyps, you may need a short course of corticosteroid tablets followed by a long-term prescription for a nasal spray. Corticosteroid tablets can cause side-effects so you should only take them for a short time.

Surgery

If your symptoms don’t improve or the nasal polyps completely block both your nasal airways, your GP will refer you to an ENT specialist for surgery. You may also need surgery if you regularly have sinusitis. This will reduce your risk of polyps coming back.

Your ENT specialist may ask you to have a CT scan of your sinuses to show the size of your nasal polyps and where they are. This helps him or her to decide on the best surgical treatment.
In polypectomy surgery, your surgeon usually removes your polyps under local or general anaesthesia. He or she uses an endoscope (this is a narrow, flexible, tube-like telescopic camera) to look inside your nose. After the procedure your surgeon or GP will usually prescribe corticosteroid drops or spray to prevent the polyps growing back.

Other types of surgery can clear out and open up your sinuses. Ask your ENT specialist for more information on different types of surgery.

Polyps grow back in around three out of four people after four years. If you think your polyps have come back, see your GP for advice.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.