I have nasal polyps. Do allergies cause polyp recurrence?

Question

Hello doctor,

I have been having a blocked nose and reduced smell for nearly a year. ENT did a nasal endoscopy and said there were nasal polyps. The CT scan showed polyps in both sinuses.

I am using a steroid nasal spray, but the relief is partial. So, my concerns are:

Are oral steroids necessary before surgery, or can sprays alone shrink them?
If I undergo FESS surgery, what is the chance of recurrence?
My allergy test showed dust mite sensitivity. Does treating an allergy help prevent polyps from coming back?
Should I continue saline irrigation daily?
Sometimes I feel mild pressure around my eyes. Is that due to sinus blockage or infection spreading?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Steroid nasal sprays reduce inflammation and shrink polyps partially, but may not eliminate larger or extensive polyps fully.

Oral steroids (such as a short course of Prednisone) can provide more rapid, significant shrinkage of polyps, improve symptoms, including smell, and reduce inflammation before surgery.

They are usually prescribed for the short term due to side effects. Studies recommend oral steroids followed by nasal sprays to augment symptom relief and polyp shrinkage for moderate to severe cases before surgery.

Oral steroids before FESS (functional endoscopic sinus surgery) surgery improve symptoms and reduce nasal mucosal inflammation, which can lead to better surgical field visibility and reduce intraoperative bleeding. Oral steroids generally provide better intraoperative conditions compared to nasal sprays alone.

Nasal polyps recurrence after functional endoscopic sinus surgery (FESS) is common, with recurrence rates reported around 30 to 70 percent within one to two years.

Recurrence can depend on various factors, including allergy status, asthma, compliance with medical therapy, and adequate postoperative care.

Allergy (dust mite sensitivity in your case) is a significant factor contributing to polyp formation and recurrence. Effective allergy management (for example, allergy medications, immunotherapy) can help reduce inflammation and may lower the risk of polyp recurrence.

Daily saline nasal irrigation is beneficial as an adjunct therapy to keep nasal passages moist, clear mucus and allergens, and improve sinus health, which can reduce symptoms and may help prevent recurrence.

Mild pressure around the eyes in nasal polyps is usually due to sinus blockage and inflammation, causing sinus pressure. It may indicate sinus congestion or secondary sinus infection if accompanied by other symptoms (fever, facial pain, worsening congestion).

This approach aligns with current ENT (ear, nose, and throat) clinical practices and research findings for nasal polyps management in adults with allergy-related factors.

I hope this helps.

Thank you.

I have nasal polyps. Do allergies cause polyp recurrence?

Are your nasal polyps well-managed?