Nasal Polyps

Nasal polyps are common, benign, swellings of the lining of the nose. In some people they may cause no symptoms, but in others they may lead to nasal obstruction, rhinorrhoea (nasal discharge), facial pressure and anosmia (loss of sense of smell). The incidence of symptomatic nasal polyps increases with age and they are more common in men than in women. The cause of nasal polyps is not fully understood but they may be associated with chronic (long-term) inflammation of the lining of the nose (termed 'chronic rhinosinusitis with nasal polyps'). Chronic rhinosinusitis with nasal polyps can be treated medically, for example with drugs such as topical (intranasal) steroid sprays, or with surgery, for example a nasal polypectomy with or without endoscopic sinus surgery (ESS). The evidence relating to the effectiveness of different types of surgery versus medical treatment for adults with chronic rhinosinusitis with nasal polyps is of very low quality (ref Cochrane Review).

ENT UK advise: “Polyps respond and shrink using drops or sprays in up to 80% of people. New nasal steroid sprays can be taken to control symptoms for many years as very little is absorbed into the body and they can work well, but many take up to six weeks of treatment before their full effect can be felt.”

Surgical intervention in the treatment of nasal polyps should be considered in patients who fail to improve after a trial of maximal medical treatment. Treatment can include: Antibiotics, Antihistamines, Nasal Douches, Nasal Steroids and Oral Steroids. Functional Endoscopic Sinus Surgery (FESS) involves the clearance of polyps and polypoid mucosa and opening of the sinus ostia (ref EPOS). The optimal surgical management of nasal polyps has not yet been established. There are very few clinical trials which compare medical and surgical treatment with the extent of surgical resection required to optimize patient outcomes, hence this is largely unknown. Inferior Turbinates are soft pieces of tissue within the nose whose function is to increase the surface area of the nasal cavity in order to warm and moisten air passing through the nose.

Enlargement of these turbinates, (due to allergy or infection), causes obstruction of the nose. Trimming these turbinates / turbinate reductions (also known turbinoplasty or turbinectomy) allows you to have more space in the nasal cavity and allows you to breathe more easily. A review from 2010 says that they conclude that the evidence in the literature is not robust enough about the usefulness of surgery using any technique for this condition” (Cochrane, 2010) & (Cochrane, 2010)


The septum, composed of cartilage and thin bone, can develop a hole within the cartilage. This can occur for a number of reasons including nasal septal surgery, autoimmune or vasculitis conditions, trauma, cancer and cocaine use. The damage reduces blood supply in the septum and the cartilage dies which results in a hole developing.