If you've been congested for months, this problem may be to blame

November 21, 2017 7:10 PM

Nasal polyps are largely benign and more accurately described as severe inflammation than as growths.

Having trouble breathing through your nose? Subject to frequent olfactory infections? Feel like your sense of smell isnt what it used to be?

Nasal polyps—or fleshy, noncancerous, skin tag-type growths inside your sinuses or nasal passages—could be to blame. Nasal polyps aren't painful, so if they're small, you might not even know they're there.

According to Abtin Tabaee, M.D., associate professor in the department of otolaryngology at Weill Cornell Medicine in New York, nasal polyps are often a symptom of chronic rhinosinusitis, a common medical condition affecting approximately 12 percent of the U.S. population and characterized by inflammation of the sinuses for more than three months.

According to the Mayo Clinic, asthma, allergies, and immune disorders can all trigger nasal polyps. Typically, they'll announce themselves with nasal stuffiness, drip, pressure in the forehead or face, snoring, and headaches. Polyps can also dull the sufferer's sense of smell and taste, and cause tooth pain—all told, the symptoms resemble those of a bad cold, but stretched out over a longer period of time.

Luckily, though, nasal polyps probably aren't cause for great concern, outside the discomfort that comes with a very stuffy nose for a very long time, and the fact that most people would prefer not to have infections. While polyps that form in other parts of the body, like the colon and rectum, can be malignant and cause cancer, nasal polyps are largely benign and more accurately described as severe inflammation than as growths, Tabaee explained.

"It is rare to have medically-dangerous complications from sinus polyps," he said. "In general, the negative impact of polyps on a patient’s health relates to the sinus and nasal symptoms as well as overall negative impact on quality of life."

To diagnose nasal polyps, a doctor might stick a lighted, camera-equipped tube (nasal endoscope) up a patient's nose to survey the situation. They also might do a computed tomography (CT) scan of the area, which allows the physician to see how severe the sinusitis is and what pattern the inflammation takes. Allergy tests and microbiologic cultures might also help diagnose chronic inflammation, Tabaee said.

Ultimately, "the goals of treatment are to control patient symptoms, with minimal exposure to medical and surgical therapy," he added. Most of the time, this entails shrinking down polyps and calming inflammation, evacuating the nasal cavity's bad bacteria and restoring the good. A doctor might prescribe broad-spectrum antibiotics, topical nasal steroid spray, saline rinse, and/or systemic steroids to treat sinusitis and polyps, while mucous-thinning medications and nasal decongestants can help mitigate stuffiness.

If medication doesn't work, you might consider endoscopic surgery—the return of that camera-tipped wand—which means widening the natural sinus outflow tracts, Tabaee explained, and removing any obstructed bone and inflammatory soft tissues. Endoscopic surgery is an outpatient procedure performed under general anesthesia, and often requires three to four days of downtime afterward. Pain typically lingers for a few days, while full recovery occurs over six to eight weeks while the patient uses saline rinse and medications to keep infection at bay.

"In an expert’s hands, the surgery is generally considered safe and is associated with positive outcomes for chronic sinusitis," Tabaee noted.

Overall, nasal polyps are a common, relatively low-grade medical concern, but if you've been feeling woefully congested for months, go see a doctor who can start you on the appropriate treatment course.

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