Understanding Nasal Polyps: Diagnostic and Treatment Pathways

Nasal polyps are benign, teardrop-shaped growths arising from chronically inflamed tissue in the nasal passages and sinuses. They are associated with ongoing irritation rather than a single cold or short-term infection. People may notice persistent blockage, postnasal drip, decreased sense of smell, snoring, pressure around the eyes, or recurrent sinus infections. Understanding what drives their formation, how they are identified, and which treatments help can clarify next steps for long-term relief.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

What causes nasal polyps?

Nasal polyps usually form in the setting of chronic rhinosinusitis, where inflammation persists for months. In many individuals, especially in the United States, this inflammation is driven by a type 2 immune pattern involving eosinophils and certain signaling proteins. Instead of resolving, the lining of the sinuses becomes swollen and fluid-filled, creating the conditions that allow polyps to develop. Infections can occur alongside polyps but are not typically the root cause; rather, they often complicate an already inflamed environment.

Nasal polyps causes and risk factors

Several conditions increase the likelihood of developing polyps. Asthma and allergic rhinitis are frequent companions, as is aspirin-exacerbated respiratory disease, where reactions to aspirin or other NSAIDs worsen nasal and chest symptoms. Chronic sinus inflammation, family history, and exposure to irritants such as tobacco smoke or air pollution can contribute. In children, cystic fibrosis is an important consideration when polyps are present. Structural issues that impair sinus drainage and immune system differences can also sustain the inflammation that encourages polyp growth.

What causes polyps in the nose?

At a tissue level, persistent inflammation disrupts the mucosal barrier that normally clears allergens, microbes, and pollutants. Immune signals such as interleukins can attract eosinophils and promote swelling. Over time, fluid accumulates within the lining, forming edematous, grape-like protrusions. Staphylococcus aureus colonization and its proteins may intensify inflammation in some people. The end result is a cycle in which impaired clearance, ongoing immune activation, and edema reinforce each other, allowing polyps to enlarge and recur.

How nasal polyps are diagnosed

Diagnosis begins with a detailed history and examination. An ear, nose, and throat specialist may perform nasal endoscopy in the clinic to directly visualize polyps and assess drainage pathways. When surgery is being considered or complications are suspected, a sinus CT scan helps map anatomy and inflammation. Smell testing and allergy evaluation can guide treatment choices, and children with polyps may be assessed for conditions such as cystic fibrosis. Red flags like a new unilateral mass, significant bleeding, eye symptoms, or severe pain warrant prompt specialist review in your area.

Treatment pathways and options

Management is typically stepwise, starting with medical therapy. Daily saline rinses help clear mucus and allergens. Intranasal corticosteroid sprays are first-line and reduce polyp size and symptoms when used consistently. Short courses of oral corticosteroids may be considered for severe congestion but should be limited due to potential side effects. For individuals with persistent, severe disease despite standard therapy, biologic medicines that target type 2 inflammation, such as dupilumab, omalizumab, or mepolizumab, may be appropriate under specialist care. Antibiotics are reserved for suspected bacterial exacerbations.

Surgery and long-term care

When symptoms remain troublesome despite optimized medical therapy, endoscopic sinus surgery can open blocked passages and remove polyps, improving airflow and the delivery of topical treatments. Surgery is not a cure for the underlying inflammation, so recurrence can occur. Postoperative care focuses on saline irrigations and continued intranasal corticosteroids to maintain results. Addressing coexisting conditions such as asthma or allergies, considering aspirin desensitization in aspirin-exacerbated respiratory disease under expert supervision, and avoiding tobacco smoke are important for long-term control.

Living with nasal polyps

Consistent daily care often makes the largest difference. Many people benefit from structured routines: saline rinses, correct technique with steroid sprays, and monitoring for changes in smell or sinus pressure. Keeping a symptom record can help clinicians tailor therapy. If congestion worsens, sleep is disrupted, or infections become frequent, reassessment by an ENT specialist or an allergy and immunology clinician in your area can refine the plan. With coordinated care and attention to triggers, most individuals achieve meaningful, sustained improvement.

In summary, nasal polyps reflect chronic inflammation of the nasal and sinus lining. A clear diagnosis, regular topical therapy, selective use of advanced treatments, and, when needed, surgery followed by careful maintenance can reduce symptoms and lower the chance of recurrence. Aligning treatment with underlying drivers, comorbid conditions, and personal preferences supports better long-term outcomes.