Medical: Polyposis nasi
Nasal polyps
English: Nasal polyps
As nasal polyps (Polyposis nasi, nasal polyps) is the name given to benign growths of the mucous membrane of the nose or paranasal sinuses. These changes are usually associated with restricted nasal breathing and, if left untreated, can lead to secondary diseases.
However, since an early diagnosis and good therapy are usually possible, polyps of the nose almost always take a favorable course. Swollen tonsils, which are often colloquially called “polyps”, are not true polyps of the nose.
The term "polyp" describes a with the naked eye (macroscopic) visible Raising of the mucous membrane (Mucosa), which usually grows pedunculated, sometimes broad-based, into the interior of a hollow organ. In principle, polyps can benign or malignant his and for example in the Sinuses, in the Intestines, the stomach or the uterus occurrence.
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Polyps of the nose are usually benign, some Millimeter to centimeter large, shiny and typically derived from the mucous membrane of Ethmoid cells (see also: Inflammation of the ethmoid cells) or the maxillary sinuses. In principle, nasal polyps can occur at any age, however, they are a rarity in children (unless there are certain diseases such as a cystic fibrosis or malfunction of the Nasal mucosa in front).
Overall, up to 12% of the total population suffer from nasal polyps, whereby Men are affected slightly more often than women. By the way, polyps of the nose occur most frequently around the age of 30.
It is true multiple triggers for polyps of the nose known, however, why polyps ultimately develop in some people with existing risk factors and not in others, has not yet been conclusively clarified.
When polyps develop in children, the underlying cause is often a metabolic disease called cystic fibrosis (cystic fibrosis). More rarely, there is also primary ciliary dyskinesia, a functional disorder of the cilia in the mucous membrane cells.
$config[ads_text2] not foundThe severity of the symptoms caused by nasal polyps depends on how large the polyps of the nose are and where exactly they are. In some cases, they do not cause any discomfort even over a longer period of time.
At some point, however, the fact that the discharge of secretion from the sinuses and, on the other hand, the ventilation of these spaces is restricted, makes breathing through the nose difficult, so that mouth breathing is increased. Due to the obstructed nasal breathing, those affected often have a nasal voice, bad breath (as the increased breathing through the mouth dries out the oral mucosa) and snoring problems.
The fact that the nose or paranasal sinuses are blocked with secretion can also lead to headaches, frequent, recurring inflammations (of the paranasal sinuses or the middle ear) or odor disorders (up to a complete lack of smell).
If polyps of the nose are left untreated for a long time, consequential damage such as widening of the nose and an enlarged eye relief (Hypertelorism) train. However, thanks to good diagnostics and therapy, these permanent changes are very rare these days.
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As part of a diagnosis, the doctor will first of all conduct a detailed survey of the medical history (anamnese) carry out. In the foreground are here Questions about risk factors how
$config[ads_text3] not foundIn addition, you will be asked exactly what symptoms are present and how severe they are. This is followed by an examination, which should be carried out by the ear, nose and throat doctor. The doctor looks at the nose and sinuses.
When the polyps are particularly large and attached easily visible places he can sometimes find it with the naked eye detect. Otherwise a Mirror and an endoscope (which is inserted through the nose, is thin and flexible and has a built-in light source) used to detect smaller, deeper-lying polyps.
With an existing Sinus infection a sample of the secretion is often taken at the same time in order to identify a pathogen.
Imaging procedures such as
If the There is suspicionthat it is also a vicious change and no polyp could act becomes one Tissue sample takenwhich are then examined under the microscope.
When polyps in the nose only slightly pronounced are usually enough medical therapyto treat them successfully. Medicines that contain the active ingredient are used cortisone included, the anti-inflammatory works.
Come into question Nasal drops or spraysthat have the advantage of being really only act locally, but hers Only take effect after a few days, or Tabletsthat are more effective, but often also with systemic side effects can go hand in hand. Often, however, treatment with cortisone is not enough.
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In such a case, a surgery carried out in which the Nasal polyps removed become. If there is only a single small polyp, most of the time it can under local anesthesia can be removed on an outpatient basis (i.e. without being referred to the hospital). Otherwise, the interventions usually take place minimally invasive (i.e. without large incisions) under the view through an endoscope through the nose under general anesthesia. The removal is done either by a tool called Nasal polyp loop or one laser.
For more extensive findings, the doctor often takes a complete one Rehabilitation of the paranasal sinuses before, in which further mucosal growths are removed or Openings from the sinuses to the nose become enlarged can. The removed material is then examined under the microscope in order to malignant degeneration to be able to exclude.
Underlying medical conditions like a cystic fibrosis, Ciliary dyskinesia, bronchial asthma and Allergies should of course be treated with nasal polyps as well to prevent permanently.
Depending on the individual clinical picture, there are different options for removing a polyp in the nose.
If the polyp is only small, it may even be sufficient if it is treated with cortisone. In some cases, however, these non-surgical methods are not enough to treat one or more polyps of the nose, and one must be surgical removal of the polyp be performed.
Surgical removal of the growth is indicated, especially if breathing is restricted by the polyp. The specialists in the field of treatment and surgical removal of polyps of the nose are specialists in ear, nose and throat medicine.
So it makes sense if people who suffer from the clinical picture go to a resident ENT doctor or to a clinic with a corresponding department. The removal of the polyp (s) (medical: Polypectomy) can be performed on an outpatient basis or under general anesthesia, depending on the individual symptoms. In the best case scenario, the attending physician can discuss with the patient which option is possible.
As a rule, a single polyp of medium size or small can be removed on an outpatient basis, while a very large polyp or multiple growths are better removed under general anesthesia.
Even if the paranasal sinuses are severely affected, removal and treatment under general anesthesia is recommended. The surgical technique is usually done minimally invasive so that no visible scars remain from the operation. The mucous membrane growths can be effectively removed with a so-called nasal polyp loop. In some cases, lasers are also used, which use high energy to remove the growth. In order to rule out malignant growths, the removed material is usually examined by pathologists. It goes without saying that if the polyps have arisen on the basis of other underlying diseases, these must be treated further. This is the only way to reduce the likelihood that the polyps will recur.
In many cases, despite everything, recurrences occur, which is why many patients need another operation after a successful nasal polyp removal after some time.
In principle, polyps of the nose take one benign course. Surgery will relieve the symptoms about 90% of patients first of all eliminated or at least significantly improved. Unfortunately tend to Polyps of the nose and sinuses however, to perform over and over again (Recurrences).
Hence a consequent follow-up treatment absolutely necessary to the use of nasal sprays containing cortisone and includes good nose care. This can significantly reduce the risk of recurrence.
Especially if you have had polyps in your nose or sinuses before, it is important to follow a few rules to avoid this To reduce the risk of recurrence.
Diseases with a increased risk of nasal polyps accompanied (Asthma, allergies, cystic fibrosis), should be recognized in good time and treated appropriately. In addition, if you suspect nasal polyps, you should definitely see a doctorin order to be able to initiate therapy quickly if necessary.
The presence of Nasal polyps is usually a diagnosis that is mainly made in adults.
When children develop nasal polyps, there is usually a disease that promotes the development of these growths. In particular, these are mostly metabolic diseases such as cystic fibrosis, also as Cystic fibrosis or a malfunction of the cilia on the lining of the nose (primary ciliary dyskinesia).
About a third of children who suffer from cystic fibrosis due to a genetic defect develop nasal polyps in the course of their lives. Therapy in children does not differ from that in adults. In most cases, surgical removal is done when the polyps make breathing difficult or cause other symptoms.
In children, it is especially important that an underlying disease is excluded if it is not known. For example, the appearance of polyps in the nose in children can be a first indication of the existence of another disease. Evidence that a child has nasal polyps can include early childhood snoring, a nasal voice and, in extreme cases, breathing problems.
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