Nasal Polyp
A nasal polyp is a soft, noncancerous growth that develops from the lining of the nasal passages or paranasal sinuses. Polyps form as a result of chronic inflammation and may range from very small and asymptomatic to large enough to block airflow or interfere with normal sinus drainage. They are commonly associated with chronic sinusitis, allergies, asthma, or certain inflammatory conditions and may occur as a single growth or as multiple polyps affecting one or both sides of the nose.
What is it?
Nasal polyps develop when the lining of the nasal passages or sinuses becomes chronically inflamed and swollen, eventually forming soft, smooth growths that often resemble small grapes or teardrops. They most commonly arise near the openings where the sinuses drain into the nasal cavity.
Polyps may affect one or both sides of the nose. Individuals with widespread or recurrent polyps frequently have associated conditions such as chronic rhinosinusitis, asthma, allergic disease, aspirin-exacerbated respiratory disease (AERD), or other inflammatory disorders.
Symptoms depend on the size and location of the polyps. Small polyps may not cause noticeable symptoms, while larger or multiple polyps can lead to persistent nasal blockage, impaired sense of smell, facial pressure, postnasal drip, snoring, or recurrent sinus infections.
Because nasal polyps and chronic sinusitis commonly occur together, symptoms often overlap significantly.
Diagnosis usually begins with physical examination and nasal endoscopy, which allows direct visualization of the nasal passages. CT of the sinuses is the preferred imaging test when more detailed evaluation is needed because it shows the extent of the polyps, sinus blockage, mucosal inflammation, and sinus anatomy. CT imaging is also commonly used before sinus surgery.
MRI is typically reserved for select situations, such as concern for spread beyond the sinuses, atypical findings, aggressive growth, or exclusion of tumors or fungal disease.
Important to Know
Nasal polyps are benign and not cancerous, but they often recur because they are linked to ongoing inflammation rather than a single isolated growth. Treatment therefore focuses not only on shrinking or removing the polyps, but also on controlling the underlying inflammatory condition.
First-line treatment commonly includes intranasal corticosteroid sprays or saline rinses. Short courses of oral steroids may be used for more severe symptoms. Allergy treatment, asthma management, and avoidance of known triggers are also important parts of long-term care.
When symptoms remain severe or polyps continue to recur despite medical therapy, endoscopic sinus surgery may be recommended to improve sinus drainage and remove obstructing tissue.
Newer biologic medications are now available for selected patients with severe recurrent nasal polyps, particularly when associated with specific inflammatory pathways or asthma.
Coordinated care with an otolaryngologist (ENT specialist) or allergist is common for chronic or recurrent disease.
Red flag symptoms include rapidly enlarging polyps on only one side of the nose, unexplained bleeding, severe facial pain or swelling, vision changes, double vision, or signs of infection spreading beyond the sinuses. These symptoms require prompt medical evaluation.