What Are Some Common Risk Factors
Not everyone develops nasal or sinus polyps. There are certain risk factors that make it more likely that youll develop them. In fact, if your sinus doctor suspects nasal polyps, theyll review these factors to determine the likelihood of polyps. Here are a few risk factors to consider:
- Sensitivity to aspirin
- Churg-Strauss syndrome, which causes the blood vessels to become inflamed and is a rare condition
- Family history of sinus problems or nasal polyps
If you have any of these risk factors, you doctor is probably already aware of them. However, if youre displaying any of the symptoms above, its worth reminding him of your additional risk factors for nasal polyps.
Can Nasal Polyps Cause Sinus Infection
Nasal polyps can cause a sinus infection by blocking how mucus flows between your sinuses and your throat.
This can cause mucus to become trapped in your sinuses, which allows germs to grow and can lead to infection.
Your doctor will diagnose nasal polyps through testing, which may include:
- a nasal endoscopy
- imaging tests like a CT scan
- allergy and immune testing
They may also recommend a full medical workup to look for other health conditions that often occur with nasal polyps.
Treatment for CRwNP is focused on decreasing inflammation in your sinuses and nasal passages to reduce your symptoms. Some treatments can help shrink nasal polyps to prevent further obstruction of your nasal cavity.
Ask your doctor about the following treatment options:
If you have a severe case of CRwNP that doesnt respond to standard steroid therapies, talk with your doctor about:
- Leukotriene modifiers. A 2013 review suggests these medications may reduce CRwNP symptoms and polyp size. The allergy medication montelukast in particular may help people who have CRwNP along with asthma.
- Biologics. Dupilumab and omalizumab are two other allergy and asthma medications approved by the Food and Drug Administration to treat CRwNP. According to a 2020 review, studies suggest that dupilumab reduces polyp size, alleviates nasal congestion, and reduces the need for surgery. Other 2020 research has found that omalizumab significantly improves symptoms and quality of life compared with a placebo.
Nasal Polyp Treatments And Covid
Medications that affect the immune response are frequently used in the treatment of nasal polyps. These include corticosteroids and biologic medications such as dupilumab.
Some people have hypothesized that since corticosteroids are known to suppress your immune response, it is logical to assume that using these medications would increase your risk of catching COVID-19 or affect your body’s ability to fight off COVID-19. However, science isn’t exactly bearing this theory out.
A case report of COVID-19 in a patient who was taking dupilumab for nasal polyps showed a very mild case of COVID-19, but this is hardly evidence for all individuals who might be using this medication.
A study conducted on chronic obstructive pulmonary disease and asthma patients using inhaled corticosteroids seemed to suggest a slightly increased risk of death of COVID-19 that correlated with higher doses of inhaled corticosteroids.
Ultimately, however, the study authors could not be certain that this was directly caused by the medication and not the underlying illness since higher doses of corticosteroids were mainly used in patients with more severe respiratory disease.
Interestingly, one inhaled steroid used to treat asthma and allergic rhinitis , ciclesonide, has been shown in some studies to inhibit the replication of coronaviruses.
There have also been a few case reports of COVID-19-related pneumonia being successfully treated using this medication. More research is needed.
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How Do You Treat Nasal Polyps
Nasal polyps are usually treated with medications first, such as nasal steroid sprays, oral steroids and nasal saline irrigations, Dr. Hur says.
Even though you cant prevent nasal polyps, the use of nasal sprays, antihistamines and allergy shots may keep them from blocking your airway. In addition, there are newer injection therapy treatments that could help prevent the polyps from returning.
If medical therapy doesnt work, another treatment option for these growths is endoscopic sinus surgery, especially if your polyps are on the larger side. This procedure often makes it easier to breathe through your nose. But its important to note that nasal polyps do tend to recur.
If left untreated, polyps can grow and obstruct the openings of the sinuses into the nasal cavity, causing difficulty sleeping, postnasal drip, fatigue and facial pressure, he says.
Your doctor can help you decide which treatment options may work best for you.
Plagued By Chronic Sinusitis You May Have Nasal Polyps
For many people with nasal polyps, life goes on without effect. These noncancerous growths can result from any number of sources and may not cause complications. However, for some people, these soft bulbs of tissue can affect your breathing, sense of smell, and even leave you prone to frequent infections.
Do you seem to catch colds every time they come along, or do the respiratory effects last much longer than the ones in those around you? You may be suffering from chronic sinusitis. For some people, the presence of large nasal polyps, or clusters of small polyps, can lead to frequent sinus infections and persistent symptoms, such as a runny nose, postnasal drip, and trouble breathing through the nose.
Without treatment, nasal polyps can lead to sleep apnea, recurring sinus infections, and more severe asthma attacks. Once diagnosed, however, there are several options that can reduce or eliminate your polyps. Dr. Franklyn Gergits and the team at the Sinus & Allergy Wellness Center can help you decide on the best course of action.
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What Is A Sinus Infection
A sinus infection, medically known as sinusitis or rhinosinusitis, occurs when your nasal cavities become infected, swollen, and inflamed. Fluid buildup in the sinuses can cause germs to grow, leading to a sinus infection.
Sinusitis is usually caused by a virus and often lasts even after other upper respiratory symptoms are gone. In some cases, bacteria or, rarely, fungus may cause a sinus infection.
Other conditions such as allergies, nasal polyps, and tooth infections can also contribute to sinus pain and symptoms.
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Are Nasal Polyps Dangerous
There is no evidence that nasal polyps are life-threatening. However, they can be a big inconvenience and can interfere with the normal drainage and ventilation of your sinuses. The mucus produced by the sinuses is meant to wash away irritants and contaminants from the nasal passages. If nasal polyps get too big, they may block the normal flow of mucus and cause it to build up and become infected, further worsening your sinus issues.
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Nasal Polyps Treated With Corticosteroids Can Make Tinnitus Worse
The number one treatment that doctors prescribe for nasal polyps is the use of corticosteroids. They will first ask you to use nasal spray corticosteroids. If that doesnt work, you might have to take oral corticosteroids. Sometimes, corticosteroids are injectables.
Corticosteroids are Ototoxic
But, some corticosteroids are ototoxic . When a drug is said to be ototoxic, it means that it can potentially harm your ear, specifically your cochlea and auditory nerve. Toxicity to your cochlea and auditory nerve can make your Tinnitus come on or get much worse. For example, oral steroids like prednisone are commonly prescribed for nasal polyps. But, prednisone can cause or worsen your Tinnitus.
Despite there being a strong correlation between corticosteroids and Tinnitus, doctors continue to prescribe steroid doses to treat primary conditions like nasal polyps, without anticipating or considering how it can worsen debilitating conditions like Tinnitus.
Acute Or Chronic Sinusitis
Almost everyone gets the occasional sinus infection, especially during allergy season. Your nasal passages fill up with mucus for days on end leading to colored discharge and facial pain, and it can become hard to breathe without keeping your mouth open. This is acute sinusitis, and you might find that nasal polyps are a contributing factor to the condition. This usually treated with antibiotics, saline rinses, and nasal sprays like Flonase etc.
However, chronic sinusitis is a condition, where you have a sinus infection that lasts more than 12 weeks. This type of infection does not resolve with antibiotics or other treatments and you wont typically run a fever or have colored discharge, but will feel run-down, constant headaches or facial pain and constantly congested.
Many cases of chronic sinusitis are the result of nasal or sinus obstruction due to nasal polyps or a deviated septum. In some cases, its both. You can get a surgical procedure done that addresses both issues at the same time.
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Surgery For Nasal Polyps
Surgery for nasal polyps is beneficial for two main reasons. First, debulking of polyps will significantly improve nasal breathing. Second, opening the sinuses improves drug delivery after the procedure.
The surgery is performed through the nostrils, so there are no external scars. Imaging technology is used during the surgery. This involves using a preoperative computed tomography scan that is uploaded into a device that guides the surgeon in real time, minimizing risks.
A new alternative to surgery called biologic therapy targets inflammatory pathways that drive polyp growth. Biologic therapy is given by injection and needs to be used long-term, Dr. Rodriguez says. Its important to be as informed as possible when making choices between surgery or biologic therapy.
The majority of people with polyps at the end of the day will get the results they want, it just depends on how they want to get there, he says. My most sincere recommendation is to gather all possible information so that you are informed and can make the best decision for your long-term care.
What Are The Treatment Options For Nasal Polyps
Depending on the number and size of the nasal polyps, your doctor may prescribe medication, surgery or both.
- Medication typically includes nasal or oral corticosteroids designed to shrink the nasal polyps or remove them.
- Surgery may be necessary in some cases to extract nasal polyps. Endoscopic surgery is typically conducted through the nose so that no incision on the skin of the face is needed.
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What Are The Most Common Causes Of Cancerous Polyps
Scientists are still trying to understand what causes polyps, as well as what makes some polyps turn malignant. Most cancerous polyps are a result of genetic changes that are inherited or occur sporadically.
Some research suggests that certain types of cancerous polyps are related to hormones or other health conditions.
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The Connection Between Nasal Polyps And Sinusitis
While not all cases of chronic sinusitis are caused by nasal polyps, there is a direct relationship between the two. When nasal polyps obstruct or hinder normal sinus drainage, they can lead you on the path to long-lasting or repeat cases of acute sinusitis. This is because polyps can make it difficult for mucus within the sinus cavities to drain, resulting in mucus build-up, inflammation, and ultimately, infection. The end result is terrible sinus pressure, pain and headaches, among other symptoms.
At the same time, medical researchers have discovered evidence that the constant inflammation that comes with chronic sinusitis may actually encourage the development of nasal polyps. Here you have a vicious circle of chronic sinusitis creating nasal polyps, which in turn can prevent normal sinus drainage and lead to sinusitis.
Along with sinusitis, there are a handful of other disorders that are also associated with nasal polyps. Both asthma and allergic rhinitis have been linked to the formation of nasal polyps, so a medical evaluation is recommended if you suffer from either condition. In addition, nasal polyps can be hereditary. So if a close family member has been diagnosed with nasal polyps, there is a greater chance that you will develop them too.
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How Does A Doctor Know Whether Its Sinus Or Migraine
Migraine is a clinical diagnosis, says Weber. That means that the doctor will ask you about your family history of migraine, allergies, and any other symptoms to determine if you have migraine or sinus headache.
To help your doctor make the correct diagnosis, it can be really helpful to track what youre experiencing, says Lauren Doyle Strauss, DO, a headache specialist and assistant professor at Wake Forest Baptist Health in Winston-Salem, North Carolina.
Write down your symptoms, says Strauss. Where is the pain located? Are you tired or dizzy? Are you sensitive to light or sound? Do you have an upset stomach or vomiting?
In addition to considering your symptoms, there can be tests used to identify sinus problems. A headache caused by a sinus infection is typically diagnosed with a CT scan of the sinuses, says Weber.
Conditions Related To Chronic Rhino
- The linings of the nose and sinuses are similar to the linings of the lungs.
- About one in five people with chronic rhinosinusitis also has asthma.
- The people most likely to have asthma are those who have chronic rhinosinusitis and nasal polyps.
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Breathing Problems Due To Nasal Polyps
It can be scary when you cant breathe easily. If your nose seems to be constantly stopped up, you may find yourself gasping for air or forced to constantly breathe through your mouth.
It might be that youre suffering from a common cold, sinus infection, or nasal polyps. When you have breathing problems, you need to visit a nose and sinus doctor, and they can make the determination as to the cause of the issue. Heres more information on breathing problems due to nasal polyps.
Types Of Chronic Sinusitis Or Chronic Sinus Infections
While acute sinusitis often involves an infection, chronic sinusitis does not. Sometimes, the long-term illness is caused by an infection that hasnt cleared up properly, but most often the exact cause of chronic sinusitis isnt known.
But clinicians may categorize chronic sinusitis into one of three types depending on the features present.
The most common type of the illness, chronic sinusitis without nasal polyposis, involves swelling and inflammation of the mucous membranes by various non-polyp factors, such as allergies or irritation and infections.
Chronic sinusitis with nasal polyposis, on the other hand, involves nasal polyps that are large enough to clog the sinus. Its not always clear why some people develop these polyps and others dont.
In chronic sinusitis with fungal allergy, people experience a strong allergic reaction to fungi in the air, which causes their mucous membranes to produce a thick, dense mucus.
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Research Questions And Future Directions
Over the past decade, there have been very important advances made in both the clinical and pathophysiological understanding of CRSwNP. However, many important questions still remain unanswered including:
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What is the true prevalence of CRSwNP within the general population or even among patients with CRS with or without asthma?
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What are the factors that trigger the development of CRSwNP?
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What role does bacteria play in CRSwNP?
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What are the precise cellular and molecular events that lead to epithelial barrier dysfunction and immune dysregulation in CRSwNP?
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What are unique biomarkers in CRSwNP that could serve as targets for potential clinical and therapeutic interventions?
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What are the underlying mechanisms by which omalizumab, mepolizumab, and dupilumab exert their clinical effects?
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Nasal Polyps And Covid
We now know that in individuals infected with COVID-19, the viral load tends to be highest in the nasal passageways and this is most likely where initial infection occurs and is spread.
An interesting finding in preliminary studies is that the virus that causes COVID-19 requires the presence of angiotensin-converting enzyme 2 to replicate. Samples of nasal polyp tissue were found to have a lower amount of ACE2 than in control tissue.
This finding could be used to hypothesize that people with nasal polyps might actually be less likely to get COVID-19. More research is needed.
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Other Reasons For Dizziness
There are many causes of dizziness. But there is a difference between dizziness or feeling light-headed vs. actual vertigo.
When you are dizzy or light-headed, you may feel like you are going to pass out. This feeling will typically become worse when you stand up and try to move around and improve when you lie down.
Vertigo, however, can cause you to feel as if the room is spinning or swaying or as if objects are moving around you. Vertigo may cause nausea and often will not improve when you lie down.
Understanding the types of dizziness you are experiencing can narrow down potential underlying causes.
How To Treat Sinus Infection
With knowing what causes sinus infection, we can know the proper treatment based on the causes.
Treatment of Acute Sinusitis
- Most non-complicated infection may respond fairly well to steam inhalation or a decongestant such as Sudafed.
- Non-prescription decongestant sprays or nasal drops may also be used to alleviate the symptoms. However, it is recommended not to use these agents for more than 4-5 days due to a potential risk of rebound congestion.
- Doctor can also recommend an antibiotic course of 10-14 days in severe bacterial sinusitis.
Treatment of Chronic Sinusitis
- Inhalation of moist warm air minimizes the congestion. Inhaling the steam of boiled water or vaporization also helps.
- Warm compresses provide relief for the pain in the sinuses and nose.
- Saline nasal drops may also be used.
- Non-prescription decongestant sprays or nasal drops are often employed to alleviate the symptoms of chronic sinusitis. However, make sure to use these agents only for the specified period of time.
- Doctor may prescribe oral steroids or antibiotics in complicated cases.
Home Remedies
Watch the video below for some extra home remedies to treat chronic sinusitis:
No matter what the sinusitis type is, treatment will certainly help. It is crucial to pinpoint the underlying cause for making the treatment successful. If the sinusitis has resulted from allergies, then decongestants cant treat it entirely on their own.
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