Treatment of nasal polyps
Nasal polyps can be treated with medications and/or surgery. Typically, medical treatments are attempted first, prior to considering surgical treatments.
Medical treatment of nasal polyps includes both topical and oral steroids. Nasal steroid sprays can help reduce polyp size by coating the lining of the nose and surface of the polyps, and thus reducing inflammation in these regions. This treatment can sometimes take several weeks to take effect. Similarly, short courses of oral steroids (pills taken by mouth) can also reduce inflammation and help shrink nasal polyps, thus improving symptoms. Oral treatment typically works quicker, however, unlike topical medication, oral steroids have numerous side effects, especially when used over long periods of time.
When medical therapies don’t work or fail to result in long term control of symptoms, sinus surgery may be considered. During sinus surgery, nasal polyps are removed from the nasal cavity and each sinus that may be affected using endoscopes, high definition cameras, and highly specialized instruments and powered devices. Unfortunately, polyps can often recur after some time despite surgery. However, there are numerous preventative options that can be used to help lower the risk of recurrence, including the following:
- Proper allergy control when indicated
- Long-term treatment of inflammation with topical steroids – this can be accomplished with specialized nasal sprays or with large volume sinus irrigation whereby liquid steroid is added to a saline filled sinus rinse squeeze bottle
- Steroid eluting stents delivering topical steroids which can be inserted into the sinuses by surgeons – these implants have been shown to reduce polyp recurrence in a number of studies
- Dupilumab, a biologic medication that targets a source of underlying inflammation that plays a major role in chronic rhinosinusitis with nasal polyps – this medication is given as an injection every other week and has been shown to reduce the need for surgery and treatment with oral steroids