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6 Health Complications of Chronic Nasal Polyps

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6 Health Complications of Chronic Nasal Polyps

Treating nasal polyps isn’t a one-and-done procedure. The complications from these growths, which develop in the lining of the nasal passages, can linger long after the polyps themselves have been removed, partly because the underlying inflammation that caused them remains.

“A misconception is that polyps just need to be removed and that that is the solution, but this is more of a chronic disease,” says Kathleen Kelly, MD, an otolaryngologist specializing in rhinology and nasal surgery at The Ohio State University Wexner Medical Center in Columbus, Ohio. “It ends up requiring years of consistent treatment.”

It’s also common for nasal polyps to return, or recur. So you’ll likely need to be monitored regularly by your doctor, who can help treat them as soon as they develop again.

The treatments for nasal polyps include steroids (as a nasal spray, taken orally, or injected), surgery, and biologics.

 “Typically, your doctor will start by treating the polyps with prednisone [oral medication] and a steroid nasal spray,” says Michael Siegel, MD, an otolaryngologist specializing in rhinology and nasal surgery at the Centers for Advanced ENT Care — Siegel, Bosworth, and Sorensen Division, in Rockville, Maryland.

If the polyps recur within a year, treatment will advance to sinus surgery. “If the polyps recur following surgery, then a biologic medication to target the inflammation, which is the root cause of the polyps, will be used to clear the polyps,” he says.

Whichever treatment you’re using, it’s important to keep it up: Both recurring and undertreated nasal polyps can increase your risk of a host of other health conditions. Here are some of the most common complications, along with ways to manage them:

1. Impaired or Lost Sense of Smell (Anosmia)

When nasal polyps grow large enough to block the nasal passage, air isn’t able to reach the olfactory nerve, which is responsible for smell, says Kibwei McKinney, MD, an otolaryngologist specializing in rhinology and nasal surgery at SSM Health Medical Group in Oklahoma City. Often, taste can also be affected.

In cases where nasal steroid sprays and oral steroids aren’t able to sufficiently shrink the polyps, doctors are increasingly turning to biologics, which have been giving people with nasal polyps the ability to smell again. “In patients on biologic medications, which target the inflammation cascade, the most incredible effect is that their sense of smell returns long term, in addition to clearing their nasal airway,” Dr. Siegel notes.

2. Feeling of Facial Fullness

Another common symptom of nasal polyps is a sensation of facial fullness and pressure, especially around the cheeks, eyes, and forehead, says Dr. Kelly. The facial pressure can be caused by the underlying inflammation, which can cause swelling of the lining of the nose and sinuses, as well as excessive mucus. This can lead to a blockage in the sinuses and nasal passages, which can cause discomfort.

Treatment will depend on what you’ve tried before for polyps, typically starting with a steroid nasal spray and then moving to surgery and biologics, says Kelly.

3. Obstructive Sleep Apnea

Nasal polyps can worsen obstructive sleep apnea, a disorder in which the upper airway repeatedly collapses during sleep, which prevents air from passing through the nose and throat into the lungs. This causes your breathing to stop for short periods, reducing your sleep quality and causing daytime fatigue, among other health issues, such as heart problems.

Nasal polyps can further restrict the airway, making it even harder to breathe. “I think of them as two different disease processes that both affect [the nose],” says Dr. McKinney.

While the standard treatment for obstructive sleep apnea is using a CPAP (continuous positive airway pressure) machine while you sleep, polyps can make it hard for the machine to work correctly. Treating the polyps will help open your nasal passages, so you can breathe properly with a CPAP.

4. Frequent Ear Infections

Ear infections can be caused by any number of factors — including something as minor as a cold — but when they occur in people with long-term, untreated nasal polyps, it can lead to eustachian tube dysfunction. With this condition, the tubes that connect the middle ear with the back of the nose become clogged and don’t properly drain fluid, increasing the risk of ear infections.

Individual ear infections can be treated with antibiotics, but if nasal polyps are the underlying cause, sticking with your polyp treatment should keep ear infections from recurring, says Kelly.

5. Infections Around the Brain, Eyes, or Sinuses

Nasal polyps can lead to chronic sinus infections. And, rarely, infections that have gone untreated for a long time can spread to the tissue around the brain and spinal cord, the tissue around the eyes, and the sinus bones (osteitis).

One such uncommon condition is bacterial meningitis, a potentially fatal infection of the fluid surrounding your brain and spinal cord that requires immediate medical attention.

6. Aspirin-Exacerbated Respiratory Disease

Chronic nasal polyps can also increase your risk of a chronic condition called aspirin-exacerbated respiratory disease (AERD). It can result in coughing, shortness of breath, wheezing, or an asthma attack after taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). (People with AERD who have nasal polyps have elevated levels of eosinophils — cells involved in inflammation — in the polyps and blood.)

To reduce your risk of AERD, make sure nasal polyps and asthma are under control, and discuss with your doctor whether NSAIDs are safe for you before taking them. If you do experience any negative reactions to NSAIDs, seek help immediately, because this emergency can increase your risk of a severe asthma attack.

By sticking to your treatment plan, following up regularly with your doctor, and keeping your care team informed of any worsening or changing symptoms, you can reduce your risk of developing related health conditions, says McKinney.

The Takeaway

  • Even after nasal polyps are removed, complications can still occur.
  • Nasal polyps are a chronic condition that requires regular monitoring from a doctor.
  • Undertreated nasal polyps can lead to health issues such as losing your sense of smell and even developing meningitis.
  • By sticking to your treatment plan and monitoring the symptoms you’re having, you can reduce your risk of developing complications of nasal polyps.

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