Whereas sinus polyps (sometimes called sinus cysts) are fairly easy to diagnose, without identifying the root cause and then following up with targeted treatment, medication or surgical removal could be a futile exercise.
Why? Because nasal polyps have a tendency to grow back within a relatively short time unless they are nipped in the bud.
When you first present your complaint to your doctor, s/he will ask a number of questions and then follow up with a physical examination of your nose.
Polyps are often detected by simply shining a light up the nostril. If not, s/he will use an instrument called an ‘Endoscope’ to examine the nasal passages in order to pinpoint the frequency, size and location of any polyps present.
Once identified, the physician should either refer you to an Ear, Nose & Throat (ENT) specialist or conduct the following tests in order to identify and treat the underlying causes:
- Computerized tomography (CT) scan: This is a type of X-ray used to produce a clear image of the nasal cavities. This will identify the exact size and location of any polyps present, together with any other abnormalities such as a deviated septum (crooked nasal passage), nasal tumors or foreign objects causing obstruction.
- Allergy tests: A qualified Allergist should carry these out. He will conduct skin prick tests on your forearms or upper back, using drops of known allergens in order to identify possible causes of nasal inflammation.
- Blood tests: If the skin tests are inconclusive, a laboratory blood test may be recommended in order to screen for specific antibodies to various allergens.
- Tests for cystic fibrosis: If the patient is a child, this test is essential. This genetic abnormality causes the overproduction of mucous that often leads to nasal growths. This is a non-invasive sweat test that measures the levels of chloride and sodium in the child’s perspiration.
Whereas fungi tests are expensive and often produce false negatives, an experienced physician can often identify symptoms of fungal allergies.
One or more of the following drug treatments may be recommended:
- Nasal corticosteroid spray: These medications are highly targeted and carry few, if any harmful side effects. They are designed to reduce inflammation, shrink polyps and sometimes eliminate them altogether.
- Oral corticosteroids: If nasal corticosteroids are ineffective, a brief course of oral corticosteroids may me recommended, either instead of or as a supplement to nasal steroids. Due to harmful side effects, this treatment should never be given for a period exceeding one week. Side effects include ailments such as hyperglycemia, insulin resistance, and bone loss leading to osteoporosis. As an alternative, your doctor may recommend a corticosteroid injection instead.
- In order to control inflammation caused by allergies, your doctor may prescribe specialized antihistamines that don’t cause the mucous membrane to dry up.
- If symptoms of fungal allergies were detected, s/he would recommend fungicidal medication.
- Chronic bacterial sinusitis may call for extended treatment with antibiotics.
Please note: A daily dose of 2 to 4 ounces of Mangosteen juice (obtainable from health food stores) may be an effective alternative to all of the above.
If medications are ineffective and fail to shrink or eliminate the polyps, your doctor may refer you to an ENT specialist. If surgery is called for, the options include:
- Polypectomy. A small mechanical suction instrument called a ‘microdebrider’ is used to remove small isolated clusters of polyps. This procedure is carried out on an outpatient basis.
- Endoscopic sinus surgery. During surgery, the ENT would carry out a sinus drainage procedure by opening the osteomeatal complex (this is a series of tubes connecting the nasal passage to the sinus cavities). At the same time s/he would straighten a crooked septum if necessary, and finally, the surgeon would remove any obstructive polyps.
After surgery, you’ll likely use a corticosteroid nasal spray to help prevent the recurrence of nasal polyps. Your doctor may also recommend a regular saltwater rinse or sinus irrigation to promote healing after surgery.