A nasal polyp is a non-cancerous growth that forms within the lining of the nose or the paranasal sinuses. These growths are soft, painless, and represent an overgrowth of the inflamed mucosal tissue. They develop as a consequence of long-term inflammation, a condition often referred to as chronic rhinosinusitis. While benign, their presence can cause significant physical obstruction and lead to troublesome symptoms that greatly impact a person’s quality of life.
What Nasal Polyps Look Like
A nasal polyp is visually distinctive. When they first form, polyps are often described as small, sac-like, and teardrop-shaped protrusions. As they enlarge, they tend to resemble a cluster of peeled grapes hanging down from the sinus or nasal lining.
The color of these growths is typically pale and translucent, appearing pearly white, grayish, or sometimes yellowish due to high water content. Unlike the normal turbinates, which are firm structures, polyps are smooth, glistening, and mobile when examined by a specialist using an endoscope. They can vary dramatically in size, ranging from tiny specks to large masses that completely fill the nasal cavity.
Common Functional Symptoms
The physical obstruction of the nasal airways causes persistent nasal stuffiness or congestion that does not resolve with typical cold or allergy medications. This obstruction frequently leads to mouth breathing, especially at night, which can contribute to snoring or other sleep disturbances.
A common symptom is the reduced or complete loss of the sense of smell, known as anosmia. Polyps block the airflow from reaching the olfactory area, preventing scent molecules from being detected. Many people also report a constant feeling of mucus draining down the back of the throat, called postnasal drip, and a sensation of pressure or fullness across the face.
The Underlying Causes of Polyp Formation
Polyps are caused by an abnormal immune response that results in prolonged inflammation of the mucous membranes, often associated with chronic rhinosinusitis (inflammation lasting twelve weeks or more). This chronic swelling causes fluid to accumulate in the tissue cells. These cells eventually become heavy and pull away from the surrounding lining, forming the characteristic teardrop shape.
A number of underlying health conditions increase the risk of developing these growths. These include asthma, which often coexists with polyps, and aspirin-exacerbated respiratory disease (AERD), characterized by asthma, polyps, and sensitivity to aspirin and non-steroidal anti-inflammatory drugs. Other risk factors are certain allergies and the genetic disorder cystic fibrosis, which causes thick, sticky mucus that promotes inflammation.
Standard Treatment Approaches
Medical management is the first line of defense, aiming to reduce inflammation and shrink the polyps. This primarily involves anti-inflammatory medications. Intranasal corticosteroid sprays, such as fluticasone or mometasone, are commonly prescribed because they deliver medication directly to the inflamed tissue.
For more severe cases, a short course of oral corticosteroids, such as prednisone, may be used to rapidly reduce the size of large polyps. High-volume saline nasal rinses also help clear mucus and inflammatory mediators from the nasal passages. In resistant cases, newer therapies called biologics, such as dupilumab, may be prescribed to target specific immune pathways that drive the inflammation.
If medical treatments do not provide sufficient relief or if the polyps are exceptionally large, surgical intervention may be necessary. The most common procedure is functional endoscopic sinus surgery, a minimally invasive operation where a surgeon uses a thin, lighted tube to remove the polyps and widen the sinus openings. Despite successful removal, polyps have a high tendency to recur, requiring ongoing post-operative medical management to prevent regrowth.