Is Surgery Necessary for Nasal Polyps ?

What is Nasal Polyps ?  

Nasal polyposis results from chronic inflammation of the nasal and sinus mucous membranes. Chronic inflammation causes a reactive hyperplasia of the intranasal mucosal membrane, which results in the formation of polyps. The precise mechanism of polyp formation is incompletely understood.

In 1990, Tos reported 10 pathogenic theories of nasal polyp formation. Multiple chemical mediators have been identified in nasal polyps but their significance has not been completely elucidated. Some of these mediators may be released by the polyps themselves and others by the eosinophils found in certain subsets of polyps. Cysteinyl leukotriene receptors and interleukin-5 (IL-5) appear to be the most well studied.

Patients with chronic allergic rhinitis; chronic sinusitis; and, less frequently, underlying disease, such as cystic fibrosis, may be at risk for the development of nasal polyps. Common presenting symptoms include nasal obstruction; chronic rhinosinusitis; exacerbation of asthma; and, infrequently, nasal and facial deformity. Nasal polyps have been associated with considerable morbidity, economic costs, and impairment in quality of life. When severe symptoms of obstruction and infection are refractory to medical treatment, surgical intervention may be required. In endoscopic sinus surgery, the goal is to remove diseased tissue and provide adequate sinus aeration in order to prevent recurrence. 

Is Surgery Necessary for Nasal Polyps ?


But it's not necessary to surgery for Nasal Polyps.  Nasal Polyps surgery can be carried out under local anesthesia with sedation or general anesthesia. Intraoperatively, extreme care must be exercised to avoid orbital and neurologic complications. The preoperative CT scan serves a vital role in proper evaluation of potential anatomic anomalies and changes due to disease process or anatomic variance.

Patients undergoing preoperative consultation must be informed of potential orbital complications, the possibility of postsurgical cerebrospinal fluid leakage, possible bleeding from related sinus arteries, and the possibility of polyp recurrence despite surgical removal. Patients should also be counseled regarding the need for close follow-up care and postoperative medical treatment for allergy, asthma, and other related medical conditions.

The following medical treatments are available  :

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What are Causes of Nasal Polyps ?

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  Chronic rhinosinusitis with nasal polyps (CRSwNP) affects about 4% of the European population.1 It is characterized by nasal obstruction, loss of smell, nasal secretions, and facial pressure. About 50% of these patients have comorbid asthma, aspirin-exacerbated respiratory disease, hypereosinophilia, or Churg-Strauss syndrome. Recurrence of the disease after surgery is high despite treatment with topical and oral glucocorticosteroids. A growing amount of evidence linking local IgE production to inflammation in patients with Nasal Polyps can be seen in the literature. Previous studies showed that specific and total IgE concentrations are increased in nasal polyps compared with those in serum or nonpolyp mucosa, illustrating an association between increased total IgE level and eosinophilic inflammation.Further studies from  independent groups also showed increased specific IgE levels in sinus tissue of patients with Nasal Polyps and greater IgE concentrations in the sinus mucosa of pat
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How to Cure Nasal Polyps without Surgery ?

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Nasal polyposis is an inflammatory condition of unknown etiology. Nasal polyps are the most common tumors of the nasal cavity. Approximately 30% of patients with nasal polyps test positive for environmental allergies.  Patients with massive nasal polyposis typically present with increasing nasal congestion, hyposmia to anosmia, changes in sense of taste, and persistent postnasal drainage. Headaches and facial pain and discomfort are not uncommon and are found in the periorbital and maxillary regions. On occasion, a patient with completely obstructing nasal polyposis presents with symptoms of obstructive sleep apnea.  Patients with solitary polyps frequently present with only symptoms of nasal obstruction, which may change with a shift in position. Coronal sinus CT scanning is the imaging study of choice in the evaluation of patients with nasal polyposis. Endoscopy in an office setting can sometimes be helpful in the diagnosis and evaluation o
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