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Tuesday, September 6, 2011

A Family Doctor's Tale - NASAL POLYPS

DOC I HAVE A NOSE POLYP

Nose Polyp is a benign tumor with soft round body rising on a stalk from the nose inner lining or nasal mucosa.

It is usually the result of chronic inflammation within the nasal cavity.

Nose Polyp can occur at any age.

The causes of nasal polyps is unknown but predisposing conditions are:
1.chronic inflammation of the nasal cavity or sinuses

2.allergies as some people with nasal polyp test positive for environmental allergen

3.Asthma

4.smoking

5.Aspirin sensitivity

Symptoms :
1.Nose Polyp is a well encapsulated round swelling rising from the nasal mucosa on a stalk called the peduncle.

2.mutiple swellings may also be present.

3.They are usually painless

4.They may block the nasal passage giving rise to the sensation of nasal obstruction.

5.There is decreased sense of smell or even complete loss of smell

6.excessive nasal secretions may also be present

Diagnosis:
1.nasoendoscopy may be done to confirm the presence of nasal polyps

2.Allergy skin tests to detect if there are any allergy contributing factors

3.CT Scan of the sinuses may be done to see the extent of the nasal polyps as well as to localize their position and other possible obstructions in the nasal cavity

There can be complications such as:
1. bleeding

2. infection of sinuses

Treatment:
Medical:
1.antibiotics to treat infections

2.antihistamine to treat allergy

Surgery:
The only surgical treatment is removal of the Nose Polyp if the medications do not work or if there is suspicion of cancer.

This can be done by nasal endoscopy sugery under general anesthesia
1.Excision of the nasal polyp with a knife or scissors through the endoscpoe

2.Clearing of any obstruction which can prevent the flow of discharge from the sinuses.

3.use of nasal steroid after surgery to prevent reccurrence of polyps

4.nasal washes to prevention the accumulation of dried mucus or crusts in the nasal cavity.

The prognosis is usually excellent.

Recurrence at the same spot is rare but do occur due to regrowth of the blood vessel supplying the Polyp.

Prevention:
Avoid any irritants or allergies as much as possible

Avoid smoking

Manage asthma or allergies with medication.

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