Examination and Diagnosis Your doctor usually makes a diagnosis based on your answers to questions about your symptoms, a physical examination, and a nasal examination. Polyps may be visible with the help of simple lighting devices.
Other diagnostic tests include: 1. Nasal endoscopy. Equipped with a magnifying glass or camera (nasal endoscope), this allows the doctor to examine the inside of the nasal cavity and sinuses in detail. The doctor inserts the endoscope into the nostril and guides the endoscope into the nasal cavity.
2.Imaging. Scanning with computed tomography (CT) or magnetic resonance imaging (MRI) helps the doctor to clarify the size and location of deep sinus polyps and to assess the extent of inflammation. These tests help doctors rule out other conditions that may be causing nasal congestion, such as structural abnormalities or other benign or malignant growths.
3. Allergy testing. Your doctor may recommend skin testing to clarify whether allergies are causing the chronic inflammation. For a skin prick test, a needle containing a small drop of the allergen (allergen) is pricked into the skin of your forearm or upper back. 15 minutes later the doctor or nurse observes for an allergic reaction. If a skin prick is not possible, your doctor may have you undergo a blood test to detect specific antibodies to a variety of allergens in your blood.
4. Screening for cystic fibrosis. If a young child is diagnosed with nasal polyps, the doctor may recommend a test for cystic fibrosis (a genetic disorder affecting the glands that produce mucus, tears, sweat, saliva and digestive juices). The standard diagnostic test for cystic fibrosis is a noninvasive sweating test to determine if the child’s sweat has a higher salt content than most people.
Treatment and Medication It is difficult to completely cure chronic sinusitis, with or without polyps. You will work with your medical team to develop the best long-term treatment plan to control symptoms and treat factors that contribute to chronic inflammation, such as allergies.
The goal of treatment for nasal polyps is to reduce or eliminate them. Medication is usually the preferred treatment. Sometimes surgical treatment is required, but may not provide permanent treatment because nasal polyps are prone to recurrence.
Medications Nasal polyps are usually treated with medications first, which can reduce or eliminate large polyps. Medications may include: Nasal glucocorticoids. Your doctor may prescribe a nasal spray of glucocorticosteroids to reduce the inflammatory response. This treatment may reduce the size of the polyp or eliminate it completely. Nasal glucocorticosteroids include fluticasone (Flonase, Veramyst), budesonide (Rayocort), flunisolide, mometasone (Nesuna), tretinoin (Nasacort AQ), beclomethasone (Qnasl, Beconase AQ), and ciclesonide (Omnaris, Zetonna).
Oral and injectable glucocorticoids. If nasal spray glucocorticosteroids do not work, your doctor may prescribe oral glucocorticosteroids, such as prednisone, either alone or in combination with nasal spray. Because oral glucocorticosteroids can cause serious side effects, they are usually used only for a short time. Glucocorticoids can be injected if the nasal polyps are severe.
Other medications. Your doctor may prescribe medications to treat chronic inflammatory disease in your nose or nasal passages. This may include treating allergies with antihistamines and using antibiotics to treat chronic or recurrent inflammation. Aspirin desensitization and treatment may be beneficial for some patients who have nasal polyps and aspirin sensitivity.
Surgery If medication does not shrink or eliminate nasal polyps, you may need to have endoscopic surgery to remove the polyps and treat the sinus disease that may be causing the inflammation or polyps to form.
To perform a nasal endoscopy, the surgeon places a small tube with a magnifying glass or small camera (endoscope) through the nostril and into the nasal cavity. The surgeon will use delicate surgical instruments to remove polyps and other lesions that block sinus drainage.
The surgeon may also widen the opening from the sinuses to the nasal cavity. Endoscopic surgery is usually an outpatient procedure. After surgery, you may need a nasal spray of glucocorticoids to prevent recurrence of nasal polyps. Your surgeon may also recommend nasal irrigation with saline (saline) to promote post-operative healing.