If you have one or more small polyps, your doctor is likely to prescribe
a corticosteroid nasal spray such as fluticasone (Flonase),
triamcinolone (Nasacort), budesonide (Rhinocort), flunisolide (Nasarel,
Nasalide) or mometasone (Nasonex). These medications relieve
inflammation, increase nasal airflow and may help shrink polyps.
Although they cause fewer side effects than oral steroids, long-term use
can lead to nasal bleeding or perforation of the septum and an increased
risk of glaucoma. Nasal corticosteroids may also reduce growth rates by
as much as one-half inch in some children, although it's impossible to
predict which children will be affected.
Other treatments for nasal polyps include:
Sometimes your doctor may prescribe an oral corticosteroid pill such
as prednisone (Deltasone), either alone or in combination with a
nasal spray. Because oral steroids can cause serious side effects,
you usually take them for a brief period — often no more than a few
In addition to treating your polyps, your doctor may prescribe
medications to control allergies or infection. Antihistamines, for
instance, counteract histamine, an inflammatory substance released
when your immune system encounters an allergen. If you have hay
fever or other allergies, antihistamines may help relieve your
congestion, although they won't eliminate polyps. In addition, your
doctor may prescribe antibiotics for an acute sinus infection.
Mayo Clinic researchers have discovered that some cases of chronic
sinusitis may be caused by an unusual immune system response to
environmental fungus. For that reason, antifungal medications are
being tested as a treatment for sinusitis-related polyps. In one
Swiss study, nasal polyps completely disappeared in 39 percent of
study participants who rinsed their nostrils with an anti-fungal
solution twice a day for 1 month. Studies of antifungal treatments
When medications aren't effective, your doctor may recommend
removing your polyps surgically. This is often the only option for
people with cystic fibrosis who usually don't respond to steroids.
The type of operation depends on the size, number and location of
the polyps. Small or isolated polyps can often be completely removed
using a small mechanical suction device or a microdebrider — an
instrument that cuts and extracts soft tissue. The procedure, called
a polypectomy, is performed on an outpatient basis. Following
polypectomy, you'll be treated for any underlying inflammation,
usually with corticosteroid nasal sprays and sometimes with
antibiotics or oral steroids. Even so, polyps frequently return, and
you may need additional operations.
Endoscopic sinus surgery is a more extensive procedure that not only
removes polyps, but also opens the part of the sinus cavity where polyps
usually form. If your sinuses are very blocked or inflamed, your doctor
may open even more of your sinus cavity. In both cases, your surgeon
uses a thin, rigid tube and a camera called a video endoscope. Because
endoscopic surgery requires small incisions, you generally heal more
quickly and with less discomfort than with other types of surgery.
Still, full recovery may take several weeks, and polyps often return.
This surgery carries serious potential risks, including leakage of
cerebrospinal fluid, injury to the optic nerve or eye muscles, and
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