Treating Nasal and Sinus Polyps

Rhinosinusitis refers to an inflammation of the tissues of the nose (rhino-) and sinuses. Polyps, tissue swellings that can form within the nose and sinuses, can be responsible for many of the symptoms described by patients with rhinosinusitis.

Polyps may simply block the nasal airway, making it difficult to breath through the nose; or they may block the proper drainage of the sinus cavities, leading to stagnant secretions that may become infected.

Polyps are generally thought to occur as a result of an ongoing inflammatory process within the nose and sinuses. Although the inflammatory process might be related to allergies, most cases of polyps occur as a result of non-allergic processes.

Whatever the cause, polyps can make patients miserable. Common symptoms in patients with nasal and sinus polyps include nasal obstruction, decreased sense of smell, recurrent sinus infections and profuse nasal drainage. Many of these patients feel as though they have a cold all of the time.

If polyps are suspected, the patient may undergo an endoscopic examination in the clinic. This procedure uses a small telescope that is placed inside of the nostril to examine the nose and sinuses. Computed tomography (often called CT or CAT scans) may help to delineate the precise location of polyps within these cavities.

After establishing the appropriate diagnosis, multiple medical treatments may be initiated. Medications include anti-inflammatory sprays, decongestants, inflammatory mediator inhibitors, and systemic steroid medications. It is important that the physician and patient recognize that medications are often needed on a long-term basis in order to reduce polyp size and prevent their re-growth.

In some cases, surgical excision of the polyps is required, using the endoscope to visualize the polyps. Following this type of surgery, it is critical to maintain medical treatment and closely observe the nose and sinus cavities to prevent recurrence of any polyps. In many cases, if a proper medical and surgical treatment plan is carefully followed, patients will not require further polyp removal surgery.

The Froedtert & Medical College Nasal and Sinus Disorders program actively participates in ongoing research in an attempt to improve treatment options for patients with recurrent polyps.

Timothy L. Smith, MD
Chief of Division of Rhinology and Sinus Surgery
Clinical Vice Chairman of Otolaryngology and Communication Sciences
Professor of Otolaryngology and Communication Sciences
Director of Nasal and Sinus Disorders Program

Todd A. Loehrl, MD
Assistant Professor of Otolaryngology and Communication Sciences

Robert J. Toohill, MD
Professor of Otolaryngology and Communication Sciences

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.