While nasal polyps often return after surgical removal, knowing your options can help keep symptoms at bay.
Nasal polyps are noncancerous (benign) growths that develop in the nose. They are seen in about 20% of people who have chronic rhinosinusitis.
You may not notice these growths at first. As they get bigger, nasal polyps can cause recurring postnasal drip, runny nose, congestion, and pain and tenderness in your cheeks and forehead.
Nasal polyps may also lead to frequent sinus infections and a reduced sense of smell.
The only way to completely remove nasal polyps is through a surgical technique called a polypectomy. However, even with surgery, nasal polyps are notorious for growing back after removal.
Curious about whether your nasal polyps may grow back after surgery?
Read on to learn about the statistics, risks, and other important information to discuss with your doctor.
Nasal polyps may be managed with medications. Steroid sprays are often the first treatment prescribed to help reduce swelling (inflammation) and polyp size.
Surgery is sometimes recommended if polyps are so large that they can’t be managed with medications, and you continue to experience uncomfortable symptoms.
However, nasal polyps will likely grow back even after surgical removal. It’s important to keep track of your symptoms and continue to consult your doctor for ongoing management.
Nasal polyps comprise soft, inflamed tissue that forms inside the nasal and sinus cavities. They can grow so large that they make it difficult to breathe.
The polyps themselves are distinct from healthy mucous membranes lining the nose. The goal of surgery is to remove the polyp tissue while leaving as much of the healthy mucus membranes as possible.
While there’s no exact known cause, nasal polyps are thought to stem from long-term inflammation. This may be related to a variety of conditions, such as:
- allergies
- asthma
- chronic rhinosinusitis
- cystic fibrosis
About 30% of adults with asthma and nasal polyps have aspirin-exacerbated respiratory disease (AERD).
People with this chronic medical condition experience respiratory symptoms such as congestion, sinus pain, and cough when they’re exposed to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs).
Most require daily treatment to help manage symptoms, but still have nasal polyps even when they entirely avoid NSAIDs.
Nasal polyps may return after surgery due to the underlying inflammation that caused them to form in the first place.
Research has revealed a high recurrence of nasal polyp growth after surgery.
One
Yet, despite the need for revision surgery, participants experienced significant improvements in smell and other symptoms.
Managing inflammation-related conditions such as allergies and aspirin sensitivity before surgery helps ensure the best outcome possible.
This might involve strategies such as taking:
- allergy medications
- allergy shots
- aspirin desensitization therapy
It is difficult to predict the exact timeline for nasal polyp regrowth. However, it’s common for polyps to grow back within a few years.
Some research has found that about 20% of those who have nasal polyps surgically removed require follow-up surgery within 5 years.
However, it’s worth noting that just because polyps regrow doesn’t mean the same symptoms will also return.
In some cases, your doctor may recommend additional treatment after surgery to help maximize the benefits of surgery, regardless of whether you’re currently having symptoms.
Some medications may also help stop the polyps from getting larger and even reduce the likelihood that you’ll need a second surgery.
Steroid nasal sprays
The most common treatments for nasal polyps, even after surgery, are nasal steroid sprays. These sprays are considered safe to use long term.
Using steroid sprays may help decrease the size of nasal polyps. They may also help reduce your symptoms and the likelihood that you’ll need additional surgery.
Doctors also usually recommend regular use of saline nasal irrigation or nasal irrigation with steroids, such as budesonide, to help keep nasal passageways clear and reduce inflammation.
Allergy medications
If you also have allergies, your doctor might recommend over-the-counter nasal sprays with fluticasone (Flonase, Xhance). These may help ease your symptoms and decrease inflammation in your nose.
In addition to nasal steroid sprays, another option for people with allergies or asthma is an oral prescription leukotriene modifier called montelukast (Singulair).
Biologics
Your doctor may recommend treatment with biologic medication, such as dupilumab (Dupixent), mepolizumab (Nucala), or omalizumab (Xolair), to help treat the underlying inflammation relating to nasal polyps.
These medications were originally created to treat asthma and allergies. The Food & Drug Administration (FDA) has also approved them to treat chronic rhinosinusitis with nasal polyps.
Antibiotics
Oral antibiotics may be prescribed if you have recurring nasal polyps that cause bacterial sinus infections. However, these are not long-term solutions and don’t help decrease inflammation or shrink polyps directly.
If you have chronic bacterial sinus infections, your doctor may recommend using an antibiotic nasal rinse. This allows the antibiotic to clear up the infection without affecting the entire body.
Intranasal polypectomy
Your doctor may sometimes recommend a less invasive nasal polyp removal procedure known as an intranasal polypectomy. This outpatient procedure involves removing the polyps with a suction device.
This procedure is usually used for those with polyps that are obstructing the nasal passages. One 2020 study found that nearly
The downside is that this procedure only addresses smaller polyps that are closer to the nostrils. It cannot treat those located deeper in the nasal or sinus cavities.
Drug-eluting stents
Drug-eluting stents are devices inserted into the sinuses following endoscopic sinus surgery. They slowly release corticosteroids into the nasal passageways to help decrease inflammation and improve wound healing. They dissolve on their own with time.
The American Rhinologic Society recommends the use of drug-eluting stents after sinus surgery to help:
- reduce inflammation
- keep nasal passages unobstructed
- reduce scarring
- prevent unnecessary surgery
- limit the need for oral steroids
Nasal polyps are commonly seen in people with chronic rhinosinusitis. While benign, these growths can cause uncomfortable symptoms that affect your daily life, including congestion, runny nose, loss of smell, and more.
Surgery is the only way to completely remove nasal polyps, and it is frequently recommended for larger polyps. However, polyps are likely to return within a few years after they’ve been removed, so you’ll likely need ongoing treatment.