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Nasal polyps

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Head or Neck

From MayoClinic.com



Although you may think of your nose mainly in terms of its appearance, it serves two vital functions: It filters, warms and moistens the air you breathe, and it transmits scent-related information to your brain.

Your nose is mainly composed of bone, cartilage and mucous membrane. Each nasal cavity contains three or four bony shelves (turbinates) that curve from the outer part of your nose toward the septum — a thin, cartilage-and-bone divider that separates your nasal cavity. A thick mucous membrane covers both the turbinates and septum. This acts as a filter to remove bacteria and dirt particles, which are swept out of your nose by tiny hairs called cilia.

When incoming air is cold or dry, the highly sensitive tissue that lines the turbinates swells, narrowing your nasal passages and slowing the flow of air so that it becomes warm and moist before reaching your lungs.

Your nose also contains olfactory nerves, which pick up scents and send the information to your brain, where the scents are identified. Without the nose-brain connection, you couldn't smell mom's apple pie or the ripeness of a fresh peach. In fact, without the olfactory nerves, you wouldn't be able to taste those foods either. That's because nearly 95 percent of your ability to taste depends on your sense of smell.

The bones behind and above your nose contain four matching sets of sinuses — hollow spaces connected to your nasal cavities by narrow channels lined with a mucous membrane. Your sinuses humidify and warm the air you breathe, aid your sense of smell and improve the sound of your voice. They also produce mucus, which drains into your nose through small openings called ostia.

How nasal polyps form

Nasal polyps can develop in the mucous lining of your nose or in one or more of your sinuses. But polyps aren't a disease. Rather, they're the end product of ongoing inflammation that may result from viral or bacterial infections, from allergies or from an immune system response to fungus. Chronic inflammation causes the blood vessels in the lining of your nose and sinuses to become more permeable, allowing water to accumulate in the cells. Over time, as gravity pulls on these waterlogged tissues, they may develop into polyps.

Risk factors

Having a condition that causes chronic inflammation in your nose or sinuses is the greatest risk factor for nasal polyps. Nearly half the children with cystic fibrosis and as many as 85 percent of people with allergic fungal sinusitis — a serious allergy to environmental fungus — may be affected. Nasal polyps also occur in a majority of people with Churg-Strauss syndrome, a rare disease that inflames the blood vessels (vasculitis). You're also at high risk if you have asthma, chronic hay fever or chronic sinus infections.

Other risk factors for nasal polyps include:

  • Aspirin sensitivity. If you're sensitive to aspirin or other products that contain salicylates, you're at higher risk of polyps than are people who don't have this sensitivity. Salicylates occur in almost all vegetables and fruits, but they're found in greater concentrations in certain manufactured products such as medicines — most notably aspirin and cold and flu remedies — solvents and perfume fixatives. If you have nasal polyps and asthma, avoid medications containing aspirin — they can cause a sudden, severe shortness of breath. More than 150 medications — most of them available over-the-counter (OTC) — contain aspirin, so read labels carefully or talk to your pharmacist.

  • Exposure to smoke and toxic chemicals. Your risk of developing nasal polyps increases if you use a wood stove to heat your home or are exposed to certain toxic inhalants at work. Outdoor air pollution and exposure to secondhand smoke don't seem to be factors, however.

  • Sex. In general, women are more likely to have nasal polyps than are men.

  • Age. Multiple nasal polyps tend to be more common in people older than 40.

Nasal polyps > 1 > 2 > 3 > 4

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