I have nasal polyps. Can they recur after surgery?

Question

Hello doctor,

I have been experiencing a blocked nose and reduced sense of smell for almost six months. A CT scan showed small nasal polyps in both sinuses.

I am using a steroid nasal spray, but not seeing much improvement yet. My eosinophil count was slightly high at seven percent. So my concerns are -

Does that mean this is an allergic-type polyp?
Can it shrink completely with medicines, or will surgery eventually be needed?
If surgery is done, do polyps tend to come back again?
Also, would taking antihistamines or using a saline rinse regularly help prevent further blockage or inflammation inside the nose, along with the prescribed steroid spray treatment?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your elevated eosinophil count suggests an eosinophilic or allergic type of nasal polyp, which is common in polyp cases associated with type 2 inflammation.

Nasal polyps with higher eosinophil involvement tend to have increased inflammation and may respond variably to treatment.

Regarding treatment,

Steroid nasal sprays are the mainstay for controlling inflammation and can reduce polyp size but may not completely eliminate them, especially if they are larger or longstanding.
Surgery might be required if symptoms persist despite medical therapy, but surgery does not cure the underlying inflammation causing the polyps.

Post-surgery, recurrence rates are significant, ranging generally from 15 % to as high as 50 % within a couple of years, especially in patients with eosinophilic inflammation or recurrent disease.

Adjunct treatments like -

Regular saline nasal rinses help by clearing mucus and allergens, reducing nasal blockage and inflammation, and enhancing the effectiveness of steroid sprays.
Antihistamines may alleviate symptoms related to allergic rhinitis but are generally less effective for shrinking polyps themselves; they can help reduce sneezing, runny nose, or itching if allergic symptoms coexist.

Maintaining long-term adherence to medical therapy after surgery is crucial to minimizing the risk of recurrence. This plan should be reviewed and customized by your ENT (ear, nose, and throat) specialist based on severity and response to therapy.

I hope this helps.

Thank you and take care.

Regards.