Why do nasal polyps form? What can we do about them? How do you know if they get worse or better?

Nasal polyps are often triggered by allergies to inhaled pollen or dust mites, animal danders, etc., but they also occur in non-allergic people, for example in cystic fibrosis, or in patients sensitive to aspirin. They are little benign sacs of eosinophil-filled fluid, which look a bit like grapes. They are silvery, translucent sacs often visible in the nasal passages. Polyps grow from a stalk based in a sinus, then grow outward toward the nasal passages and upon filling of this area, can cause obstruction of airflow to the olfactory nerves (therefore decreasing sense of smell), and often obstruction of the sinus openings, leading to chronic sinus infections.

Treatment: Debulking surgically is sometimes helpful temporarily, but there is a high rate of recurrence of polyps after surgical removal -- and it could be 20 yrs later, or 6 weeks later. So, we try to go with medical treatment and allergen avoidance first. The only medications that significantly shrink nasal polyps quickly are those containing a corticosteroid. Oral corticosteroids like Medrol or Prednisone can be very effective in reducing nasal polyps temporarily. However, to avoid long-term side effects, once the polyps shrink down, treatment can be switched to a topical nasal steroid spray indefinitely. You would likely be able to tell if your nasal polyps are recurring based on symptoms (severe nasal congestion or obstruction, loss of sense of smell, recurrent sinus infections). If allergies are present, allergen immunotherapy ("allergy shots") may help keep nasal polyps under control as well.