Nasal Polyps

Nasal polyps are soft, painless, grape-like swellings of the lining of the nose and sinuses. They are the visible part of a long-term inflammation called chronic rhinosinusitis with nasal polyps, and they usually grow on both sides.

They are not cancer. They block airflow and smell and tend to come back, because the inflammation behind them persists. Treatment controls the disease in most people but often has to be continued for years.

Symptome

• Blocked nose on both sides
• Reduced or lost sense of smell and taste
• Runny nose or mucus running down the throat
• Pressure or fullness in the face
• Snoring and mouth breathing
• Repeated sinus infections
• Worsening of asthma

Ursachen und Risikofaktoren

In most adults the polyps arise from a type 2 inflammatory response, the same pathway that drives asthma and eczema. About half of those affected have asthma, and some have aspirin-exacerbated respiratory disease, where aspirin and similar painkillers trigger nasal and chest attacks. Allergic fungal sinusitis is another cause. Polyps in a child are unusual and should prompt testing for cystic fibrosis. Polyps on one side only need a careful look and often a biopsy to exclude a tumour.

Wie es diagnostiziert wird

• Nasal endoscopy: A thin camera in the clinic shows the polyps directly and grades their size.
• CT of the sinuses: Shows how far the disease extends and is needed before any operation.
• Allergy and blood tests: Eosinophil count, total IgE and skin prick tests help select treatment, including biologics.
• Lung function: Checks for asthma, which should be treated together with the nose.
• Biopsy: For one-sided or unusual-looking polyps.

Behandlungsmöglichkeiten

• Steroid nasal sprays, drops and rinses: The basis of treatment. Daily saline rinsing plus a steroid spray or steroid-containing rinse shrinks polyps and delays return.
• Short courses of steroid tablets: Give quick relief and often restore smell for a time, but side effects limit repeated use.
• Endoscopic sinus surgery: Removes polyps and opens the sinuses so that sprays and rinses reach the lining. It improves symptoms reliably but does not cure the inflammation.
• Biologic injections: Dupilumab, mepolizumab or omalizumab for severe disease that returns after surgery. They are long-term treatments given every 2 to 4 weeks.
• Aspirin desensitisation: An option in aspirin-exacerbated disease, done under specialist supervision.

Wenn es dringend ist

Swelling or redness around an eye, double vision, a severe headache with fever, a stiff neck or confusion in someone with sinus disease can mean that infection has spread and needs emergency care the same day.

Reisen nach Türkiye zur Behandlung

Endoscopic sinus surgery is a planned procedure that fits a visit of about a week, and a CT plus endoscopy can settle whether it is worthwhile. Be clear that surgery is one step. Rinses and sprays continue afterwards, a few clinic cleanings are needed in the first weeks, and polyps return in a sizeable share of patients over the years. Biologic injections need regular supply and monitoring, so they should be prescribed where you live.

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