What Nasal Polyps and How They Can Be Treated?


What is the cause of nasal polyps?
Currently it is not known exactly. Several factors can influence its appearance: the chronic inflammations of the mucosa, the alterations of blood vessels that supply the mucosa, mechanical problems such as the increase of these tissue fluids; alterations in the development of the cavity nasal, creating negative pressures, and the allergic component.

Nasal polyps occur in isolation or associated with other diseases such as asthma, aspirin intolerance and respiratory diseases (impaired mucus-producing glands, abnormal cells responsible for mobility of mucus).

An important feature of nasal polyps is the presence of a specific cell type. This cell is known as eosinophil. If the number of eosinophils is very high, the process is usually a chronic, eosinophilic because produces proinflammatory substances.

What symptoms cause nasal polyps?
The main symptom is nasal obstruction of one or both nostrils.Large polyps prevent nasal breathing, forcing the individual to breathe through your mouth.They can also cause a decrease or loss of sense of smell. If evolution has been long, the polyp can even poke through the nostril.

How are nasal polyps diagnosed?
The diagnosis is made primarily by symptoms of nasal obstruction and loss of smell in the patient.Here, we explore the inside of the nose with an instrument called rhinoscope, which allows you to view the internal structures through the nostril. You can also use a small camera that is inserted through the nostril and enables the entire cavity of the nose.Thus, other causes may be distinguished. Both the review by rhinoscope as TeleScopia fibroscopy or sit in an objective diagnosis.

You can have a CT (computed tomography), which are scans, for details of the location and size of polyps, as well as how these are the sinuses, to perform surgery.

It can also be a brushed mucosal cells and analyzed for, or take a shot of biopsy , in order to view the tissue microscopically. Both tests provide information for the cause of nasal polyps.

What other problems can cause obstruction of the nose?
A poor nasal breathing, in addition to causing nasal polyps, can be caused by diseases of the mucosa of the nose, such as allergy to pollen, dust, mites, fungi and animals, as well as a very important sensitivity to environmental conditions unhealthy environment, such as breathing excessively dry air, polluted with fumes and constant or sudden changes in temperature, due to air conditioners. The overuse of medication to breathe better, as vasoconstrictors, also can block the nose. Can also be produced by other structures swelling of the inner part (turbinate) or deeper obstructions thereof.In very rare cases, the cause may be a tumor.All these circumstances are carefully studying the otolaryngologist, to make a correct diagnosis of nasal obstruction.

Is there medication?
When polyps are small, may be treated with corticosteroids local application by the nasal cavity nebulizers or orally, using tablets or tablets.These treatments can produce a decrease in size of polyps and, in some cases, make them disappear.  All treatment with corticosteroids should be strictly as instructed, to get the maximum benefit and to avoid the side effects of these drugs, as they are often important.

They can also accompany these treatments with antibiotics and antihistamines, depending on the state in which it is the evolution of nasal polyps, or problems associated infectious. Next to this is added the cause or treatment of the factors are known.

In most cases the treatment of nasal polyps is usually mixed with medications and surgery.

What is the best way to treat nasal polyps?
The most effective treatment is surgery.The surgery of nasal polyps should be performed on three assumptions:
– When there is a complete nasal blockage of one or both holes .
– Where there is a persistent infection with sinus involvement .
– In patients who do not improve with corticosteroid repeated treatments, or those in which these treatments are contraindicated, such as those suffering from glaucoma (increased eye pressure), diabetes , tuberculosis or high pressure.

How is the operation of nasal polyps?
The operation is called a polypectomy. Is usually performed with anesthesia general, in almost all cases. Local anesthesia is used in patients who have a contraindication to be anesthetized, because other diseases of the body.The purpose of the operation is not only the removal of polyps in the nasal cavity, but also clean the sinuses, respecting all healthy structures.

Currently, surgical techniques have evolved a lot in this field, mainly due to advances in imaging techniques. It uses a small chamber which is embedded in a rigid cylinder of only several millimeters in diameter and about 15-20 inches long.  Also carries a powerful light within, to illuminate the whole nasal cavity. With this camera, you have different lenses with different angles, you can see every corner of the nasal cavity, the posterior part, which is in communication with the throat, the roof and sides, which is where most polyps.The camera is connected to a TV monitor, and operate according to the otolaryngologist will go directly viewing the image on the TV. Surgical instruments are adapted to this technique and consist of specially designed materials to suction, cut, open and clean, both the nasal cavity and sinuses.

Before operating, if indicated, corticosteroids are administered, with the aim of reducing as much as possible the size of the polyp and make more effective the intervention.

The nasal cavity is an organ that has many blood vessels, since the nose is responsible for cleaning the air, heat and moisten.Therefore infiltrates whole nasal cavity anesthetic and vasoconstrictor and prevent bleeding. It is injected into the mucosa and polyps root.

Keep in mind that the operation of nasal polyps is not intended to cure the disease, but only to the elimination of symptoms that are polyps.

A special type of nasal polyp is a polyp of Killian antrochoanal. This polyp born in one breast and goes through the inside of the nasal cavity to the rear thereof, growing palate behind and being able to observe times behind the bell, when the patient opens the mouth.The operation of this type of polyp requires removal or at least some deflection of nasal structures.

The results with the use of lasers in nasal polyps operation are similar to the use of conventional surgical instruments. Normally, plugging is performed both holes for about 48 hours, to control bleeding.

Are there any complications?
Complications may arise are: nosebleed, due to the large number of blood vessels in the area, problems in connection with the eye due to its proximity to the nose area lesions skull lower contiguity, and synechiae, which are junctions between various parts of the nasal cavity to produce a narrowing of the air passage. All these problems do not typically occur when the operation makes a very experienced, and in the case of the solution is immediately and satisfactory in most cases.

Can nasal polyps reproduce?
Unfortunately, nasal polyps usually reproduce, because the operation has no effect on the cause thereof.Operation with Local anesthesia is less effective due to performance limitations. The operation under general anesthetic is more effective, and delayed reproduction of polyps in a while, even for years. Once the operation of nasal polyps should be given medical treatment with corticosteroids, which are those that help control the development of nasal polyps.

When to see a doctor?
When you can not breathe through your nose, the doctor will examine the cause, to put the appropriate remedy.

Dr. Robert Mills , a specialist in Otolaryngology