Chronic Sinusitis with Nasal Polyps
Chronic sinusitis with polyps is an inflammation of the sinuses that lasts more than 12 weeks and is associated with nasal polyps. In the Michigan area, and probably in the U.S. in general, this condition accounts for a large portion of the sinus surgery performed.
In general, as polyps swell or get larger, they start to fill the nose and cause nasal blockage or obstruction, which some patients refer to as “congestion."
For a person with allergies and polyps, a “bad allergy day" will frequently cause the polyps to swell more and cause more symptoms. Likewise, treating a patient’s allergies will often cause the polyps to shrink somewhat and may give some relief from the blockage.
As polyps get larger, filling 75% to 90% of the nasal cavity, patients really start to complain of nasal obstruction, and this often motivates them to seek medical care.
When polyps fill the entire nose, patients are miserable. They can’t breathe through their nose at all so they mouth breathe during the day and at night.
Why Diagnosis is Important
Because patients can’t breathe through their nose, they mouth breathe while sleeping, causing them to snore. Sometimes nasal polyps can make snoring severe enough to tip a patient who snores over to sleep apnea – which has a substantial effect on patients.
Patients with sleep apnea don’t sleep well, and they are at higher risk for other health problems, including heart disease, heart attack, stroke, and memory and concentration problems.
Frequently Asked Questions
- What is a polyp?
Polyps arise when the tissue lining the nose, called mucosa, becomes very inflamed and swollen. The normal mucosa, which is pink, moist, and 1 to 2 millimeters thick, can become swollen with fluids and proteins until it resembles a fluid-filled sac.
- Why do polyps form?
Polyps form as a reaction to inflammation or allergy. In addition, patients with an inflammatory disease (not necessarily due to allergies) in the nose and sinuses may have polyps grow in the nose and sinus.
- I can’t taste anything very well. Why?
When there are polyps filling about 50% or more of the nose, the air in the nasal cavity is blocked and does not reach the area where the smell nerves are located. When air and odors can’t get to the nerve endings, then a person can’t smell well, or may not smell anything at all – and therefore can’t taste well, either, because much of our sense of taste is related to our sense of smell.
- What can be done, before surgery, to reduce or eliminate polyps?
The treatment for polyps depends on what is causing them, so it is very important to get a thorough evaluation of the polyps in order to obtain the best treatment. Before surgery, we may want to try:
- Steroid Sprays
Steroid sprays are prescribed for most types of nasal polyps, particularly mild polyps caused by allergic rhinitis (allergies to cats, dust, molds, pollens, trees, grasses and/or molds). They are also used for patients with medium and large polyps. Steroid sprays are helpful in shrinking polyps or slowing their natural growth.
- Steroid Pills
Steroid pills will cause a dramatic shrinkage of the polyps, but the effect is usually temporary – a few days or a few weeks. While the fluid in the polyp is dramatically reduced, the inflammatory cells and tissue remain; after stopping the steroids, the water returns to the polyps and they often return to their original size, if nothing else is done.
- Steroid Sprays
Why Come to Michigan for Treatment?
- We treat more than 5,000 patients every year.
- We take a multidisciplinary, step-by-step approach that takes you – as a whole person – into account.
- If you need us for surgery, know that we perform more than 500 surgeries every year. And, when it comes to surgery, experience counts.