Nasal Polyps

Sinonasal polyps are commonly seen in patients at Southern California Sinus Institute and are believed to be the end-stage result of chronic inflammation within the nose and sinus cavities. The polyps are non-cancerous growths and are usually seen bilaterally in patients. They often resemble a cluster of grapes.(Figure) Patients will often complain of many of the same symptoms as patients with chronic sinusitis such as smell and taste changes, recurrent sinus infections, chronic facial pain, and rhinorrhea. However these patients have a significantly increased tendency toward severe nasal obstruction. As such many patients with this condition are diagnosed with “chronic rhinosinusitis with sinonasal polyposis”.

The etiology in 1/3 of patients with sinonasal polyps is believed to be allergic and as such aggressive medical treatment of the allergies in these patients is critical to their long-term management. However 2/3 of patients with this condition do not have allergies and the offending culprits may include chronic fungal sinusitis, severe bacterial infections, or other conditions causing severe inflammation of the nose and sinuses. For example, patients with asthma and aspirin sensitivity have a predilection for sinonasal polyps and often aspirin desensitization can significantly improve their outcomes. However in a great majority of these patients who develop sinonasal polyps, the cause is never identifited. Nonetheless, many of the same measures utilized in allergic patients to reduce inflammation within the nose and sinuses will prevent the recurrence of these polyps and their associated symptoms.

The treatment of sinonasal polyposis often includes regular use of intransal steroids, antihistamines, leukotriene inhibitors, oral steroid pulses, intranasal steroid injections, saline sinus rinses and Minimally Invasive Image-Guided Sinus Surgery (MIGSS) as performed by Dr. Cohen. If allergies are identified to be the source of the polyps, then allergy shots (desensitization) is also advocated. If fungal disease is identified to be the source, then antifungal medications may also be instituted. The important aspect of treating this complicated disease is to develop an individualized treatment plan which may or may not include surgery to address the cause of your polyps and treat its associated symptoms.