Sinuses are cavities in the facial bones around or near the nose. Four categories of sinuses exist in pairs on both side of the nose. They are sphenoid, maxillary, frontal and ethmoid sinuses. Normally sinuses cavity is filled with air. The sinuses cavities are lined with mucosa which is mucous producing tissues. Nasal polyps are non cancerous growth developed in the linings of nose and sinuses. Nasal polyps are yellowish brown or pink in color and they vary in size. Polyps generally grow in both the nostrils. They may grow in clusters or grow as singular ones.
Large polyps or polyps in clusters can cause breathing difficulties and can affect the patient’s sense of smell. They may block the orifices of the sinuses obstructing the flow of mucous and consequent infections in the sinuses. People with sinus infections, allergic problem and who suffer from asthma are more prone to the development of sinus polyps.
Symptoms
1) Runny nose: A patient with polyps in the sinus feels that he is always under the influence of cold.
2) Persistent blockage of nose: Patients with polyps in their nose feel that their nose is blocked and find it difficult to breathe through the nose.
3) Post nasal drip: People with polyps in nose feel that mucous in continuously running down the throat.
4) Sense of smell: Sense of smell is lost or reduced in the case of people with polyps in their nose.
5) Poor sense of taste, headache, pain in face and snoring are also common symptoms of this type of patients.
Diagnosis
An ENT specialist or a general medical practitioner will be able to conduct a preliminary diagnosis based on the symptoms shown by the patient. He will examine the patient’s nose with the help of a lighted instrument. He may also ask the patient to undergo a CT scan. Nasal endoscopy is a procedure in which a small camera connected to a flexible wire in inserted to the nose of the patient and magnified video of the images taken by the camera are transmitted to the monitor placed in front of the doctor. This procedure will help him pin point the correct position where the polyps grow and the extent of the growth of the polyps. In the case of a child patient a test called cystic fibrosis will be done which measures the sodium and chloride content is the child’s sweat.
Treatment
As an initial step the doctor may prescribe nose drops or steroid spray. This will help in reducing the inflammation and shrinks the polyps. This treatment option is practiced only when the polyps is small in size and in numbers. For larger polyps steroid tables are prescribed either along with the sprays already stated above or independently. Other medications like antibiotics, antifungal drugs and antihistamines for allergies will be prescribed by the doctor according to the requirements of the individual cases.
Surgery
Surgical procedure is used only if the conventional treatments have not yielded any fruitful results, or if the polyps are extremely large.
Polypectomy: This is the most common procedure in practice for the removal of nasal polyps. This is usually done under general anesthesia. Surgeon enters the polyps’ area through the nostrils. In this procedure the surgeon removes some pieces of bone from the nasal area in addition to the removal of polyps to eliminate the possibility of recurrence.
Endoscopic sinus surgery: In this procedure an endoscope which is a surgical camera connected to one end of a flexible tube is inserted through the nose. Through other small cuts in the face of the patient other miniature tools for the surgery are inserted and the surgeon performs the surgery by viewing the enlarged video of the sinus and the surgery in the camera placed before the surgeon. The polyps are removed by the surgeon and the orifice of sinuses are also cleared by him.