Nasal polyps: understanding blockage, loss of smell and treatment choices.
Nasal polyps are soft, usually painless and non-cancerous growths arising from inflamed lining inside the nose and sinuses. Treatment is aimed not only at removing blockage, but at controlling the underlying inflammation and maintaining long-term sinus health.
Symptoms often develop gradually.
Small polyps may cause few symptoms. Larger or multiple polyps can obstruct the nasal passages and sinus drainage pathways.
Persistent stuffiness or difficulty breathing through the nose.
Smell may become weak or absent; taste can also seem reduced.
Mucus may drain from the nose or down the throat.
Some patients develop facial pressure, headache or repeated sinus problems.
A polyp is not simply “extra tissue.”
Nasal polyps commonly occur in the setting of chronic inflammation of the nose and sinuses. Asthma and sensitivity to aspirin or related medicines may coexist in some patients. Because other conditions can also cause nasal obstruction, persistent or unusual symptoms deserve proper examination.
Diagnosis starts with examination, not with a scan alone.
History
Duration of blockage, smell loss, discharge, sinus symptoms, asthma, allergy and prior treatment.
Nasal examination
The nose is examined for visible obstruction and associated disease.
Endoscopy
A nasal endoscope can define the location and extent of polyps and assess drainage pathways.
CT when indicated
CT of the sinuses may be useful in extensive disease, uncertain diagnosis or surgical planning.
Individual plan
Treatment depends on symptoms, extent of disease, previous therapy and associated conditions.
For many patients, treatment begins with inflammation control.
Intranasal corticosteroid sprays or drops are commonly used to reduce inflammation and polyp size. Saline irrigation may help clear mucus and improve nasal care. Selected patients may need a short course of systemic corticosteroid under medical supervision.
Associated allergy, asthma or infection is treated when clinically relevant. In selected patients with severe or recurrent chronic rhinosinusitis with nasal polyps, specialist teams may consider biologic medicines after appropriate assessment.
Do not self-prescribe repeated steroid tablets.
Systemic corticosteroids can have important adverse effects and should be used only when clinically indicated and supervised. The choice, dose and duration of treatment depend on the individual patient.
Endoscopic sinus surgery is considered when symptoms and disease remain significant despite appropriate treatment.
Surgery is performed through the nostrils using an endoscope. The aim is to remove obstructing polyps and, when required, open affected sinus drainage pathways so ventilation, drainage and ongoing topical treatment can be improved.
Surgery is not a guarantee that polyps will never return. Long-term medical care and follow-up often remain important after an operation.
Maintenance matters.
Saline irrigation and prescribed intranasal corticosteroid therapy are commonly part of postoperative care. Follow-up allows healing to be assessed and recurrent inflammation to be detected early.
Not every blocked nose should be assumed to be polyps.
Arrange ENT assessment for persistent nasal blockage, progressive loss of smell, recurrent sinus symptoms, or symptoms that do not respond to routine treatment. One-sided symptoms, recurrent bleeding or an unusual nasal mass deserve particularly careful assessment.
Seek urgent medical care when symptoms escalate rapidly.
Urgent assessment is appropriate for significant swelling around the eye, new double vision or other visual change, severe or rapidly worsening headache, marked forehead swelling, neurological symptoms, or any rapidly deteriorating condition.
Preparing for an ENT consultation
Bring a list of previous nasal medicines, details of asthma or drug sensitivity, allergy history, prior sinus operations and any previous CT scans or reports. Mention how long smell has been affected and whether symptoms are on one side or both.
Patient-information note
This page provides general education and does not diagnose an individual condition. Examination, nasal endoscopy, imaging and treatment decisions should be based on a clinician’s assessment of the individual patient.