What Happens if Nasal Polyps Go Untreated?

Nasal Polyps
If left untreated, nasal polyps can cause serious health problems, including these 7 medical complications.

It's difficult to predict what will happen if nasal polyps are left untreated because so little is known about why they grow in some people's nasal passages but not in others.

Nasal polyps can be asymptomatic and go unnoticed in some people. Others may experience a great deal of discomfort and frustration as a result of them.

People dismiss nasal polyps, assuming they are a boil or a common infection. When nasal polyps go untreated, they can cause serious health problems. They should not be ignored, even if they aren't usually serious.

7 complications of untreated nasal polyps

  1. If left untreated, nasal polyps can eventually block your nose.
  2. They can make it difficult to breathe through your nose and may make sinus infections more common.
  3. In severe cases, polyps can become so large that they can be seen simply by looking into the nose. If polyps are left untreated for an extended period, the constant pressure can cause the nose to widen and the space between the eyes to narrow.
  4. Polyps can occasionally grow out of control and cause damage to nearby structures, such as your eye or brain if left untreated.
  5. Nasal polyps obstruct and reduce enjoyment in daily activities, as well as make patients feel embarrassed in social situations. Polyps can also bleed, which can be uncomfortable and, in rare cases, lead to anemia.
  6. Polyps in some people block the part of the nose that allows them to smell. Unfortunately, even after the polyps have been removed, the sense of smell may not return.
  7. If you ignore nose polyps in the hope that they will go away on their own, you are at risk of developing:

Unfortunately, nasal polyps will persist and possibly grow for as long as the condition that caused them exists.

Large polyps can harm your health. What is usually a minor and temporary annoyance can quickly escalate into a major issue. Large polyps can even result in deformity. As the small bones in the nose shift as a result of growth, the face can appear enlarged.

Although uncommon, polyps can sometimes press on nerves and impair vision.

What are nasal polyps?

Nasal polyps are teardrop-shaped growths that can form in the lining of your nose, most commonly where the sinuses open into the nasal cavity. They are not cancerous and are frequently the result of chronic sinusitis's ongoing swelling and irritation.

You may not even be aware that you have polyps if they are small. However, the larger they are, the more likely they are to cause problems.

14 signs and symptoms of nasal polyps:

  1. Runny nose
  2. Congestion
  3. Sneezing
  4. Loss of smell and taste
  5. Postnasal drip
  6. Headache
  7. Sinus pain
  8. Pain in the upper teeth
  9. Pressure over the face, including the forehead
  10. Itchiness around the eyes
  11. Nosebleeds
  12. Snoring
  13. Feeling blocked in your nose and having to breathe through your mouth
  14. Trouble sleeping

Consistent nasal polyp symptoms are inconvenient on their own and may indicate chronic issues that should be addressed sooner rather than later. Furthermore, because nasal polyps have the potential to develop into more serious symptoms, prolonged symptoms should be investigated as soon as possible.

What are the possible causes of nasal polyps?

Nasal polyps can form when the mucous membranes that line the nasal passageways and sinus cavities become inflamed repeatedly or over a long period. Infections and allergic reactions are to blame, as these incidents cause inflammation, redness, and fluid build-up in the passageways.

Inflammation can then lead to the formation of small, fluid-filled growths, which develop into nasal polyps. Some people develop nasal polyps at random, but most of the time, there is a triggering mechanism.

The common triggers for nasal polyps include the following:

  • Asthma
  • Hay fever/allergic rhinitis
  • Chronic sinus infections
  • Cystic fibrosis
  • Sensitivity to aspirin and other nonsteroidal anti-inflammatory drugs
  • Genetics and family history may play a role, with certain genes predisposing you to have inflamed nasal tissues

It's safe to say that any condition that irritates your nasal passages or sinuses puts you at risk for nose polyps.

Nasal polyps primarily affect adults over the age of 40 years and are more common in men than in women. According to statistics, between 19 and 36 percent of people with chronic sinusitis have nasal polyps. Around 7 percent of asthmatics also have chronic sinusitis with nasal polyps.

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How do I get rid of nasal polyps?

Nasal polyps are a chronic condition that must be treated regularly to prevent them from worsening. A good way to prevent this from happening is to create an environment in which they struggle to thrive.

Avoiding prolonged exposure to irritants, managing asthma properly, and practicing good hygiene are all simple ways to keep polyps out of your nasal passages and sinuses.

Typically, the first line of defense of nasal polyps includes:

  • Nose drops containing xylometazoline and oxymetazoline (constrict the blood vessels underlying the sinuses and reduce swelling)
  • Corticosteroid sprays
  • Medicines to help decrease inflammation (antileukotrienes)
  • Saline rinses and steroid nasal sprays must be used daily and do not always provide relief because the medicine is difficult to reach the polyps
  • Aspirin desensitization therapy, if appropriate

Drops and tablets are typically steroid-based, which means they're a great short-term fix, but the long-term side effects may not be worth it.

Some common non-surgical options professionals may use to treat and remove nasal polyps include:

  • Nasal corticosteroids and oral steroids, which shrinks the polyps and improve symptoms
  • Antibiotics
  • Antihistamines, which are oral pills that relieve allergy symptoms
  • Allergy immunotherapy (injections) that deliver targeted Dupilumab, an antibody used to treat allergic diseases such as nasal polyps
  • Stent insertion is an outpatient procedure in which a small stent is inserted into your nasal passageway, opening it up and delivering medication to the area

When considering how to remove nasal polyps, there are times when nonsurgical treatment is ineffective and surgery becomes a viable option.

Nasal polyps treatment and surgery

  • When non-surgical treatments fail to remove nasal polyps, surgery becomes necessary. It may appear drastic to operate on something that causes only minor discomfort, but the truth is that the symptom list discussed is not exhaustive.
  • While many of the symptoms of nasal polyps are difficult to distinguish from those of a common cold or allergy, larger polyps are difficult to overlook, because they can be quite bothersome if left untreated. That is why, when medication fails, surgery is required.

There are two surgical options for nasal polyp removal:

  1. Endoscopic surgery:
    • In this procedure, the doctor inserts a small tool with a tiny camera called an endoscope into the nostril, which will be guided to the area where the nasal polyps are located to remove them and drain any backed-up fluid.
    • They may also use this opportunity to enlarge the cavities to lessen the severity of symptoms if the nasal polyps reappear.
    • Endoscopic sinus surgery is typically performed as an outpatient procedure, which means the patient can return home immediately.
    • Because there is no need for an incision, the patient does not have to deal with thick bandages covering the nostrils afterward.
    • You must follow the doctor's instructions regarding medications after surgery.
      • Corticosteroids or a saline nasal spray are common treatments.
      • Even though the polyps will be removed during surgery, there may still be inflammation in the nasal passage or the sinuses.
      • This will be treated with medication to reduce inflammation and prevent the likelihood of the nasal polyps returning.
  2. Septoplasty:
    • A septoplasty, also known as surgery to repair a deviated septum, is another option for surgical removal of nasal polyps. When the septum cartilage is crooked, it can cause nasal issues.
    • The goal of a septoplasty is to straighten the cartilage to help clear the nasal passage.
    • After making the incision, the doctor will lift the mucus membrane that sits atop the cartilage to expose the cartilage and bone to reshape or remove it entirely.
    • This is also when the doctor will remove any nasal polyps. Once the nasal passage is clear, the doctor will replace the mucus membrane with stitches and splints.
    • The procedure takes less than two hours, and you will have cushioned packing in your nose for up to 24 hours.
    • Following that, the patient can resume normal activities with some restrictions to allow the incision to heal properly.

Side effects of medical and surgical treatment of nasal polyps

  • While steroids are effective in treating symptoms, oral steroids do not target nasal polyps specifically. This means that the steroids may circulate throughout the body and, if used repeatedly, may cause serious safety issues such as high blood sugar levels, infections, bone loss, adrenal suppression, and eye complications.
  • If there is a lot of bleeding during your procedure, the surgeon may decide to leave the packs inside your nose for an extra day. If there is a lot of bleeding after the pack is removed, the surgeon will insert it again using local or general anesthesia.
  • The sides of the nose may stick together as they heal with bands of scarred tissue called adhesions in people with narrow nasal passages. This can be released in an outpatient clinic.
  • There is a minor risk of infection in the operation area. If you experience increasing pain in the cheekbone or nose, a headache, or a fever, an infection is likely developing and you should seek medical attention immediately. Usually, taking antibiotics for a week or two solves the problem.
  • In rare cases, the infection can be severe and spread to the ear, face bones, and sinuses, as well as the bloodstream. If this occurs, you will need to return to the hospital to be treated with intravenous antibiotics.
  • Polyps can reappear in some people. This could happen within a year or several years later. It is impossible to predict whether your polyps will reappear; only time will tell.

Despite endoscopic sinus surgery being performed half a million times per year in the United States, and symptoms may be temporarily relieved, repeat surgery is frequently required because sinus surgery is not a cure.

Nasal polyps can be effectively treated with both medication and nasal polypectomy. The key is to consult with a specialist, such as an otolaryngologist, to determine which treatment plan is best for you.

References
Image Source: iStock Images

What Happens With Untreated Nasal Polyps Over Time? A 13-Year Prospective Study: https://pubmed.ncbi.nlm.nih.gov/27189153/

Nasal Polyps: https://www.cedars-sinai.org/health-library/diseases-and-conditions/n/nasal-polyps.html Nasal Polyps: https://gaapp.org/what-are-nasal-polyps/