Nasal Polyps

Question 1

What are the main sites in which nasal polyps are found

Answer 1

Middle turbinate
Middle meatus
Ethmoids

Question 2

Causes of nasal polyps

Answer 2

Asthma
Aspirin sensitivity (Samter’s triad)
Allergic/non-allergic rhinitis
Cystic fibrosis
Neoplasms
Cystic fibrosis

Single, unilateral polyp → ?sinister pathology
Glioma
Lymphoma
Sarcoma
Nasopharyngeal carcinoma
Neuroblastoma

Question 3

Symptoms and signs of nasal polyps

Answer 3

Water, anterior rhinorrhoea
Nasal osbtruction
Sinusitis
Snoring
Headaches
Purulent post-nasal drip

Rhinoscopy: mobile, pale, insensitive lump

Question 4

Investigations for nasal polyps

Answer 4

Clinical diagnosis - rhinoscopy

Single, unilateral → ?sinister cause → CT, biopsy and histology

Question 5

Management of nasal polyps

Answer 5

Routine referral to ENT for examination (do medical therapy in the meantime)

Medical (topical steroids (betamethasone drops) 4-6w → short course of oral steroids)
Surgical (endoscopic polypectomy)