Nasal Polyps are non-cancerous growths that form inside the nose that can happen to anyone at any age. They can cause a lot of discomfort and pressure in the face, especially when they block your airway. If you are so afflicted, we want to help you find the best nasal polyps treatment so you don't need to suffer anymore. Fortunately, there are 14 different ways to help treat nasal polyps.

14 Most Common Options for Nasal Polyps Treatment

1. Managing Allergies and Asthma
​Although the causes of nasal polyps are not well known, if you have allergies, asthma, or both, the mucus and inflammation that result from these conditions can lead to blockages in your sinuses and nasal passages. Seeing an allergist to talk about the best steps for treatment could be very beneficial.

2. Avoiding Nasal Irritants
Certain allergens and irritants may contribute to the growth of nasal polyps. To prevent this, try your best to avoid breathing in any airborne substances that could make your condition worse. These include chemical fumes, dust, cigarette smoke, smog, and strong smells (like cologne).

3. Washing Hands
Frequently Washing your hands frequently reduces the chance of bacterial or viral infections that can cause inflammation in your nose, sinuses, and nasal passages. 

Make sure you are always washing your hands before you touch your face, blow your nose, and after you use the washroom.

4. Humidifier or Vaporizer
If the air in your home or work area is too dry, your nose and sinuses won't move mucus well, leading to congestion and inflammation that could instigate the development of polyps. Using a humidifier may help moisten your nasal passages, improve mucus flow from your sinuses, and prevent blockages. If a central humidifier is not an option, there are portable units that you can easily move around to whatever room you're in.

However, it's crucial to clean the humidifier on a regular basis to prevent bacteria from growing. Also, be careful not to over-humidify the air; too much moisture can cause the growth of mold and fungi in your home, which could irritate your sinuses or make you sick. A good rule of thumb is to keep the indoor humidity levels at no more than 50%.

5. Saline Sprays or Nasal Rinses
Rinse your nasal passages with a saline spray or nasal wash to loosen mucus. This can help improve mucus flow and remove allergenic particles. Also, use saline to rinse off your nasal septum, which can help prevent crusting.

7. Nasal Corticosteroids 
Many people with nasal polyps are likely to be prescribed a nasal spray to reduce inflammation. This therapy can help shrink the polyps or even get rid of them entirely. In order to work locally, the particles need to reach the surface of the polyps. Nasal corticosteroids sprays such as mometasone (Nasonex) are approved for nasal polyps in the front of the nasal cavity. Corticosteroid rinses, often using budesonide, reach the nasal cavities as well as some of the sinus cavities in patients who have had sinus surgery. Corticosteroid administered with an exhalation delivery device, such as Xhance, has also shown effectiveness in reaching the upper sinuses where nasal polyps tend to arise. 

8. Oral Corticosteroids
Oral corticosteroids - like prednisone - may be used if a nasal corticosteroid doesn't do the job. Prednisone can be used by itself or together with a nasal spray to temporarily reduce nasal polyps. Keep in mind that peak corticosteroids can have systemic side effects.

9. Dupilumab (Dupixent), Mepolizumab (Nucala), and Omalizumab (Xolair)Another option is a class of drugs called monoclonal antibodies, including dupilumab (Dupixent), Mepolizumab (Nucala), and Omalizumab (Xolair), which are injections that help control severe nasal polyps as an add-on therapy. Studies show that this treatment can reduce nasal congestion, impressive sense of smell, decrease a patient's need for future surgery. They also treat other inflammatory conditions, including asthma and atopic dermatitis.

10. Aspirin Desensitization
If you have AERD (Aspirin-Exacerbated Respiratory Disease) with recurring nasal polyps, your doctor may prescribe a strategy called aspirin desensitization to help reduce inflammation and swelling. This treatment entails a series of diluted doses of aspirin until you reach a corrective level. This therapy can significantly reduce inflammation and help shrink polyps over time.

11. Surgery
Large nasal polyps, especially when significant chronic sinusitis is present, may need to be surgically removed. You are usually put under general anesthesia at a hospital or outpatient surgery center for this procedure. The doctor uses an endoscope to get a view of the inside of your nasal passages and uses special equipment to remove the polyps without needing to make an incision on your face.

The removal is sometimes performed in conjunction with other surgeries that help treat issues that cause polyps. For example, Functional Endoscopic Sinus Surgery is a procedure that increases your sinuses' drainage pathways to prevent mucus build-up that could cause polyps in the future. Chronic sinusitis can also be treated with a procedure called Balloon Sinuplasty, in which a small balloon catheter is placed inside your sinus passageway. The balloon is dilated to widen the nasal passage and then gently removed.

12. Allergen Immunotherapy
​Another treatment used in patients with nasal polyps is immunotherapy. This therapy makes the body less likely to produce substances that can lead to inflammation in your nose, sinuses, and nasal passages. Immunotherapy can be administered sublingually or as a subcutaneous allergy shot.

13. Dietary Changes 
​Certain foods and beverages may trigger inflammation, allergies, or asthma symptoms in some people. Salicylates are thought to contribute to aspirin exacerbated respirator disease and contribute to nasal polyps growth. Avoiding them may help alleviate the symptoms. 

Nasal polyps can be caused by many different things, from allergies to bacteria. Airway inflammation and diseases are something we take very seriously. That's why we perform research and bring specialists like ENTs, allergists, pulmonologists, and neurologists together for meetings on how to best treat patients. Join the Snot Force today to learn more!

Smell loss can be devastating to quality of life. 

SNOT FORCE researchers have identified significant associations of smell loss with COVID-19, discovering early on how people performed online search queries for smell loss even before smell loss became a known symptom of COVID-19. SNOT FORCE member, Dr. Elisa Illing, was recently interviewed for her expertise in this area of research.

WTHR 13 talked to Dr. Illing as she described smell training therapy as a way to recreating smells, much like physical therapy for the body.

​--
Elisa Illing, MD is Assistant Professor, Chief of Rhinology and Anterior Skull Base Surgery at Indiana University and Secretary and Executive Board Member of Snot Force Alliance Inc. 

Our study showed that endoscopic sinus surgery is by far the most cost-effective way to improve symptoms of severe nasal polyp disease. It provides quick and profound relief.

The management strategies for chronic rhinosinusitis with nasal polyps (CRSwNP) in adults have improved immensely over the past decade. And add-on medicines, from sprays to rinses to biologics, are vital in controlling the associated inflammatory cascade. Some people need minimal maintenance while others need whatever you can give them!

The idea is to keep people feeling great and avoiding more harmful medicines like long-term oral corticosteroids.

Chronic rhinosinusitis with nasal polyps is a more complex disease than people think. It can take the form a mild severity to very difficult-to-control. CRSwNP can be associated with several other conditions, such as asthma and allergic rhinitis. It can also be related to an infectious process, such as staphylococcus aureus superantigens. Each of these factors play a role in how this condition is optimally treated. 

NEW SNOT FORCE STUDY PUBLISHED!

Check it out.

Are antibiotics were necessary with nasal packing?

ABSTRACT

OBJECTIVE: Nonabsorbable nasal packing is often placed for the treatment of epistaxis or after sinonasal or skull base surgery. Antibiotics are often prescribed to prevent toxic shock syndrome (TSS), a rare, potentially fatal occurrence. However, the risk of TSS must be balanced against the major risk of antibiotic use, specifically Clostridium difficile colitis (CDC). The purpose of this study is to evaluate in terms of cost-effectiveness whether antibiotics should be prescribed when nasal packing is placed.

STUDY DESIGN: A clinical decision analysis was performed using a Markov model to evaluate whether antibiotics should be given.

SETTING: Patients with nonabsorbable nasal packing placed.

METHODS: Utility scores, probabilities, and costs were obtained from the literature. We assess the cost-effectiveness of antibiotic use when the risk of community-acquired CDC is balanced against the risk of TSS from nasal packing. Sensitivity analysis was performed for assumptions used in the model.

RESULTS: The incremental cost-effectiveness ratio for antibiotic use was 334,493 US dollars (USD)/quality-adjusted life year (QALY). Probabilistic sensitivity analysis showed that not prescribing antibiotics was cost-effective in 98.0% of iterations at a willingness to pay of 50,000 USD/QALY. Sensitivity analysis showed that when the risk of CDC from antibiotics was greater than 910/100,000 or when the incidence of TSS after nasal packing was less than 49/100,000 cases, the decision to withhold antibiotics was cost-effective.

CONCLUSIONS: Routine antibiotic prophylaxis in the setting of nasal packing is not cost-effective and should be reconsidered. Even if antibiotics are assumed to prevent TSS, the risk of complications from antibiotic use is of greater consequence.

LEVEL OF EVIDENCE: 3a.

Otolaryngol Head Neck Surg. 2021 Feb 16:194599820988740. doi: 10.1177/0194599820988740. Online ahead of print.

PMID:33588621 | DOI:10.1177/0194599820988740
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Best,

Thomas Higgins, MD, MSPH
President
Snot Force Alliance Inc

Some ear symptoms are ultimately related to the nose, our research group found. The intertwined anatomy and physiology of these two body parts makes for a logical association. The nose is connected to the ear via a functional tube called the Eustachian tube. This tube helps ventilate, drain, and maintain an equilibrium of air pressure in the middle ear. It opens in the back of the nose called the nasopharynx. If something were to block that opening, the system gets backed up, causing increased ear pressure and ear fluid.

We have known that one of the causes of ear infections or persistent middle ear fluid in kids is obstruction of the Eustachian tube from the adenoids, which are in the nasopharynx. Thus, performing an adenoidectomy is one of the treatments for chronic ear fluid in kids.

Our research group set out to see if chronic rhinosinusitis affected ear symptoms in adults and our findings were significant. We found that, in patients with chronic rhinosinusitis, ear symptoms and nose/sinus symptoms were strongly correlated. So, those with worse sinus symptoms seemed to have worse ear symptoms.

We also looked at how sinus surgery affected ear symptoms. In this study, 80% of the patients had improvement in ear symptoms with sinus surgery alone and 60% had complete resolution (or normalization) of their ear symptoms!

​So, we have found it important to ask questions about both nose and ear symptoms because treating the nose is often the answer to solving certain ear problems.

We’re putting together a team with a nose-worthy mission of fighting all that is s-naughty. Puns aside, our goal is to create a network of like-minded medical professionals across multiple different specialties to educate our peers and our patients and to advance our field by collaborating on cutting edge research together. All the while, our priority will be to have fun and make meaningful connections. Join the SNOT FORCE and add comments below.