ENT - nasal polyps

Question 1

What are nasal polyps?

Answer 1

Growths of the nasal mucosa that can occur in the nasal cavity or sinuses

Question 2

Nasal polyps are associated with

Answer 2

Chronic rhinitis or sinusitis

Asthma

Samter’s triad (nasal polyps, asthma and aspirin intolerance/allergy)

Cystic fibrosis

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

Question 3

Presentation of nasal polyps

Answer 3

Chronic rhinosinusitis

Difficulty breathing through the nose - may have to breathe through mouth so wake up with dry mouth for example

Snoring

Nasal discharge

Loss of sense of smell (anosmia)

Post-nasal drip

Question 4

Examination in nasal polyps

Answer 4

Nasal cavity examination with speculum

Can also test smell, respiratory system and examine the oropharyngeal cavity

Question 5

How do polyps look on nasal speculum examination?

Answer 5

Nasal polyps appear as round pale grey/yellow growths on the mucosal wall.

Question 6

Management of nasal polyps

Answer 6

Unilateral polyps - refer for specialist

Medical management is with intranasal steroid drops/spray

Surgical management can be used if medical management fails
- Polypectomy

Intranasal polypectomy is used where the polyps are visible close to the nostrils
Endoscopic nasal polypectomy is used where the polyps are further in the nose or the sinuses

Question 7

Important features to ascertain in order to not miss malignancy

Answer 7

Unilateral polyps

Bleeding