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Nasal Polyps: Symptoms, Causes, Diagnosis, Treatment and Surgery Recovery

Apr 27, 2020
3 min read

Updated: Oct 3

Key takeaways

  • Nasal polyps are soft, painless, non-cancerous growths of the lining of the nose and sinuses, appearing as pale, grape-like swellings.

  • They affect about 1–4% of adults and are rare in children; they usually appear after the age of 20.

  • They are linked to chronic inflammation: chronic sinusitis, allergies, asthma, aspirin sensitivity, fungal sinusitis and genetic predisposition.

  • Medical treatment (steroid sprays and sometimes short courses of oral steroids, and biologic drugs for severe cases) is the first step; endoscopic sinus surgery removes polyps that do not respond.

  • Polyps can recur, so long-term follow-up and maintenance treatment are important.

Nasal Polyp

What are nasal polyps?

Nasal polyps are fluid-filled swellings of the nasal and sinus lining. They are different from the turbinates, which are normal anatomical structures, although enlarged turbinates are sometimes mistaken for polyps. Polyps form when chronic inflammation causes swelling and fluid accumulation in the mucosa. Small polyps may cause no symptoms; larger ones block airflow and sinus drainage.

How do polyps form?

Factors that promote polyps include:

  • Allergies (about 30% of people with polyps have allergies)

  • Asthma

  • Aspirin sensitivity (aspirin-exacerbated respiratory disease)

  • Chronic sinusitis

  • Upper respiratory infections

  • Fungal sinusitis

  • Genetic predisposition, including cystic fibrosis in children

Symptoms

  • Persistent nasal congestion or blockage

  • Runny nose, clear or coloured, and post-nasal drip

  • Reduced or lost sense of smell and taste

  • Facial pressure or pain around the forehead and cheeks

  • Snoring and, in severe cases, sleep apnoea

  • Frequent sinus infections

Diagnosis

Diagnosis is made by examining the nose with an endoscope, which shows the size and location of polyps. A CT scan shows how far they extend into the sinuses and helps plan surgery. Allergy tests and, when needed, asthma evaluation are added. Rarely, a one-sided polyp is biopsied to exclude other conditions.

Treatment

Medical treatment

  • Nasal steroid sprays or rinses to shrink polyps and control inflammation

  • Short courses of oral steroids for large polyps, under medical supervision

  • Saline irrigation

  • Allergy treatment

  • Biologic medications for severe, recurrent polyps associated with asthma

Surgical treatment

When polyps do not respond to medication or cause significant blockage, functional endoscopic sinus surgery (FESS) removes the polyps through the nostrils and opens the sinus drainage pathways, with no external incisions. Surgery can be combined with septoplasty or rhinoplasty when there are also structural or aesthetic concerns. See sinus surgery and rhinoplasty.

Frequently asked questions

Do nasal polyps develop later in life?

They are acquired, not present at birth, and most often appear in adulthood, typically after 20.

Can polyps come back after treatment?

Yes. Recurrence is common in people with asthma, allergies or aspirin sensitivity; ongoing steroid sprays and follow-up reduce it.

At what age do nasal polyps occur?

Mostly in adults over 20; in children, polyps should prompt evaluation for conditions such as cystic fibrosis.

Can I notice polyps myself?

Large polyps may be seen just inside the nostril, but most are only visible with an endoscope.

Are polyps single or clustered?

They often occur in clusters on both sides, varying from small to large.

How long does polyp surgery take?

Usually about 1–2 hours depending on extent.

When will I recover after polyp surgery?

Most people return to normal activities within 1–2 weeks, with crusting settling over several weeks.

When will I breathe easily after surgery?

Breathing often improves once internal swelling and crusts settle, typically within 2–4 weeks.

Next step

Contact Prof. Dr. Suleyman Tas Clinic for an endoscopic assessment with Prof. Dr. Suleyman Tas.

About the author

Prof. Dr. Suleyman Tas is a European Board-certified plastic, reconstructive and aesthetic surgeon based in Istanbul with over 20 years of experience, author of Rhinoplasty in Practice (CRC Press) and founder of the Closed Atraumatic Rhinoplasty Course. Read verified patient reviews or book a consultation.

This article is for general information and does not replace an individual medical consultation.

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