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Nasal Polyp Surgery

Dr. Sumaiya Khan
Nasal polyps are benign growths that develop in the lining of the nasal passages or the paranasal sinuses. The surgical removal of nasal polyps is recommended when the use of oral steroids or steroid nasal drops or sprays fails. The following write-up provides information on the nasal polyp surgery and aftercare.
Nasal polyps are abnormal tissue growths that develop in the mucous membranes that line the nose and the paranasal sinuses. These are categorized into antrochoanal polyps and ethmoidal polyps. While antrochoanal polyps arise from the lining of maxillary sinuses, ethmoidal polyps arise from the lining of the ethmoid sinuses.
These could develop singly or in clusters. The medical conditions that are characterized by the chronic inflammation of the nasal passages or the sinuses can put a person at an increased risk of developing nasal polyps.
Allergic rhinitis, rhinosinusitis, asthma, aspirin sensitivity, cystic fibrosis, and Churg-Strauss syndrome are some of the medical conditions that are associated with the formation of such growths.
While small polyps are likely to be asymptomatic, symptoms may be experienced if a large polyp blocks the nasal passages. Under these circumstances, the affected individual is likely to experience symptoms such as nasal congestion, runny nose, sneezing, change in voice, postnasal drip, loss of the sense of smell and taste, etc.
Though doctors often recommend the use of steroidal nasal sprays or drops for treating nasal polyps, nasal polyp surgery is recommended when drug therapy is found to be ineffective.

Surgery for Nasal Polyps

While large polyps can be seen on examining the nostrils, small polyps in the nasal passages or the sinuses can be detected with the help of nasal endoscopy. Surgical intervention may become a necessity for large nasal polyps that cause distressing symptoms and alter the shape of the nose.
Polypectomy and endoscopic sinus surgery are both surgical procedures that are performed for the removal of polyps. These procedures are done on an outpatient basis. Here is some information about these procedures.

➊ Polypectomy

Doctors recommend polypectomy for patients who have been diagnosed with a small nasal polyp. Before the procedure, mucus or other nasal irritants are removed by nasal irrigation. Local anesthetics are injected into the nose. During the procedure, the patient remains under the influence of a general anesthetic.
A nasal speculum or a clamp is used for holding the nose open. After the polyp is located, it is removed with the help of a suction device, or a cutting tool called microdebrider. The remnants of the polyp or the tissues are extracted with forceps. Packing is placed in the nostrils to control bleeding. A small dressing may also be applied under the nose.

➋ Endoscopic Sinus Surgery

An endoscopic sinus surgery is recommended when the sinuses are blocked by large or recurring polyps. This procedure is also performed under general anesthesia. This surgery involves the use of an endoscope, which is a tube with a camera at one end.
During this procedure, the endoscope is inserted into the nostrils to detect the location of polyp and the affected sinuses. Specialized instruments are then inserted to remove the polyp and/or any other source of obstruction that may be present in the sinuses.
During the surgery, the openings that connect the sinuses to the nasal cavity may also be widened. Packing and gauze dressing are applied after the removal of polyp to control bleeding.

Recovery Time and Aftercare

The recovery period for the aforementioned surgical procedures ranges from 1-3 weeks. Rest is advised for a couple of days. The person who has undergone this surgery may have nasal congestion and nosebleeds for 2-3 days.
Painkillers and antibiotics may be prescribed for alleviating postoperative pain and lowering the risk of infection. The effect of the anesthetic drugs stays for a day, which is why anyone who has undergone this surgery must follow certain precautionary measures.
Do not drive or handle machinery for 24 to 48 hours after the surgery.
Refrain from blowing your nose.
Do not smoke or drink alcohol.
After the surgery, the nasal cavities are packed with cotton and gauze so as to absorb blood. This gauze packing needs to be changed periodically.
◘ After removing the packing, rinse the nasal passages with saline solution. This will remove the remnants of blood or blood clots that may form in the inner lining of the nasal cavities. Nasal irrigation also lowers the risk of an infection. It also helps in promoting healing by keeping the sinuses moist.

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One of the risks associated with this surgery is heavy bleeding. Contact your doctor immediately if heavy bleeding persists.
Large nasal polyps that don't respond to drug therapy need to be removed through surgery. It must be noted that nasal polyp surgery cannot rule out the possibility of recurrence of such growths. However, the risk can be reduced by following precautionary measures and the guidelines given by the doctors in the postoperative visits.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.