How do I manage a nasal polyp and persistent nasal congestion?

Question

Hello doctor,

For the past several months, I have had persistent nasal congestion, a reduced sense of smell, and constant pressure around my face. My ENT specialist suggested that these symptoms may be due to nasal polyps. I have tried nasal sprays and allergy medications, but the symptoms keep returning. I am concerned because my breathing feels blocked most of the time, especially at night.

Could you explain why nasal polyps develop, whether surgery is the only solution, and what long-term management options are available to prevent recurrence?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The symptoms you described, persistent nasal blockage, reduced sense of smell, facial pressure, and limited relief with sprays, are indeed a possible cause of nasal polyps.

Nasal polyps are non-cancerous, soft tissue growths that develop due to chronic inflammation in the nasal passages and sinuses. This inflammation may be triggered by conditions such as chronic sinusitis, allergies, asthma, or certain immune responses. Over time, the inflamed nasal lining swells and forms these polyp-like growths, which lead to obstruction and reduced airflow.

The first-line approach is usually medical management, including:

Fluticasone: Long-term use helps shrink or control polyps.
Prednisone: Short courses may be prescribed for severe swelling, under medical supervision.

Treatment of underlying triggers such as allergies, sinus infections, or asthma. If symptoms remain severe despite optimal medical therapy, endoscopic sinus surgery may be considered to remove the polyps and improve airflow. Surgery often provides significant relief but does not cure the tendency to form polyps.

I would suggest the long-term management to prevent recurrence:

Continued use of maintenance Fluticasone (topical nasal corticosteroid spray) even after surgery.
Regular nasal saline rinses to keep the sinuses clear.
Identifying and controlling allergy or asthma triggers.

In some cases, newer biological therapies such as Dupilumab may be recommended, especially for patients with frequent recurrence or associated asthma.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.