CONDITION / CARRY

Polyposis rhinosinusitis.

Polyposis rhinosinusitis is a chronic inflammation of the nose and sinuses, in which polyps grow in the nose: soft, benign growths of the mucous membrane, usually on both sides. The main complaints are congestion and loss of smell.

Discuss your case How it is treated in the clinic ↓

CONCEPTUAL VISUALIZATION

BRIEFLY

what is it: Chronic inflammation of the nose and sinuses with polyps — benign growths of the mucous membrane.
How often: In a large Austrian study, polyps were found in 1.84% of ENT clinic patients.
Main signs: Blockage of both halves of the nose and loss of smell.
Who treats: ENT doctor; with asthma - together with a pulmonologist or an allergist.

01 / WHAT IS IT

What are
polyps in the nose.

Polyps in the nose are not a tumor, but a swollen and enlarged mucous membrane of the nose and sinuses. They look like smooth grayish grapes, usually grow on both sides and narrow the nasal passages.

Polyps are a manifestation of chronic rhinosinusitis: inflammation that lasts more than 12 weeks. About a third of people with chronic rhinosinusitis have polyps.

Polyposis rhinosinusitis is often combined with asthma. One of the most severe options is the so-called aspirin triad, when intolerance to aspirin and other nonsteroidal anti-inflammatory drugs is added to polyps and asthma.

This is general information. How to treat you, the doctor will tell you after the endoscopy and CT scan.

02 / SIGNS

How
polyps appear.

From chronic rhinosinusitis without polyps, polyposis is most distinguished by the loss of smell; without polyps, the face hurts more often.

Obstruction on both sides

The nose is breathing worse and worse, the drops are of little help.

Loss of smell

Odors weaken or disappear completely; taste suffers along with smell.

Allocation

Mucus from the nose or on the back wall of the pharynx.

Pressure in the face

Heaviness in the sinuses, especially when inflamed.

Snoring

Due to congestion, a person snores and sleeps poorly.

03 / REASONS

Why
polyps grow.

Polyps are the result of long-term inflammation of the mucous membrane, most often of a special, "second type", as in asthma and allergies.

Asthma

Polyps and asthma have a common mechanism; together, they are more severe and less amenable to treatment.

Aspirin intolerance

The combination of polyps, asthma and a reaction to aspirin is one of the most severe forms of the disease.

Chronic inflammation of the sinuses

Polyps are one of two types of chronic rhinosinusitis. According to the combined data of 4 studies, chronic rhinosinusitis with polyps is present in approximately 0.65% of people.

Chronic sinusitis

Gender and heredity

Men and people with asthma have larger polyps; hereditary factors and the environment play a certain role.

04 / SEEK MEDICAL ADVICE

When to seek urgent medical care?

Polyps usually do not require emergency care. But inflammation of the sinuses can rarely spread to the eye socket or the skull cavity.

103 immediately if:

swelling of the eyelids, pain when moving the eyes, double or impaired vision;
severe headache with high temperature or neck stiffness;
an attack of dysentery after taking aspirin or other non-steroidal anti-inflammatory drugs.

See an ENT doctor in the coming days if:

Polyp or blockage on only one side, bleeding or pain. Unilateral formation always needs examination. If the nose gradually stops breathing and the sense of smell has disappeared, make an appointment for a scheduled consultation.

05 / DIAGNOSTICS

How the
diagnosis is made.

Nasal endoscopy
The doctor sees the polyps and assesses their size.
CT scan of the sinuses
Shows which sinuses are affected - needed for planning surgery.
Asthma and allergy
They check whether there is no asthma, allergy or intolerance to aspirin.
Histology
Unilateral or unusual formations are examined under a microscope.

06 / TREATMENT

How to treat
polyps in the nose.

Polyposis rhinosinusitis is a chronic disease. The goal of treatment is to restore breathing and smell and to control inflammation for a long time.

Medicines

Hormonal sprays: The basis of treatment. In a Cochrane review (40 studies, 3,624 patients), they reduced the symptoms and size of polyps and, after surgery, the risk of their recurrence.
A short course of hormonal pills: At the end of the course (2–3 weeks), the condition improves, but after 3–6 months the effect almost disappears; insomnia and digestive disorders are possible.
Biological therapy: For severe cases; in an Austrian study, 6–14% of patients with polyps met the EPOS criteria.

Endoscopic surgery

When medicines do not help: for example, after 8 weeks of local treatment and more than 2 courses of hormonal pills.

Removal of polyps and opening of sinuses: Through the nostrils, the surgeon removes the polyps and opens the affected sinuses so that the sprays can work better in the future.
The result: The operation reliably improves the quality of life; sense of smell improves in about half of patients.
Regrowth: Polyps often return: after 18 months — in 40%; at least 10–15% require reoperation within 4 years. The risk is higher after previous operations and with large polyps.

07 / AT THE VALIKHNOVSKY CLINIC

How do we
treat it.

Polypous rhinosinusitis is operated on at the Dr. Valikhnovsky Institute of Surgery in the "New Nose" direction - endoscopically, through the nostrils.

DIRECTION TO THE CLINIC A new nose Shape, support and breathing of the nose: septum, concha, sinuses, consequences of injuries, failed operations and removal of tumors. Go to direction

What do we do in this condition

Polypotomy, in particular shaverna — removal of polyps with a rotating instrument under the control of an endoscope.
Ethmoidotomy — opening of cells of the ethmoid bone, from where polyps most often grow.
Endoscopic microhygrotomy — if the maxillary sinuses are also affected.

Rostislav Valikhnovsky

Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovsky Institute of Surgery.

About the doctor ORCID

How is the treatment in us

ConsultationTalk about smell, asthma and preliminary treatment, nasal endoscopy.
CT scan of the sinusesDetermines the scope of the operation.
PlanAre sprays enough, is surgery necessary, and what to do after it.
OperationEndoscopically, through the nostrils; the tissue is sent for histology.
After surgerySprays and follow-up examinations with endoscopy to detect regrowth in time.

Discuss your case to call

08 / QUESTIONS AND ANSWERS

Frequently asked
questions.

Short answers. What is right for you, the doctor will tell you during the consultation.

Can you get rid of polyps without surgery?

Hormonal sprays reduce polyps and symptoms, a short course of hormonal pills lasts for several weeks. If this is not enough, polyps are removed endoscopically.

Will polyps come back after surgery?

They can: In a study of 363 patients, polyps returned in 40% after 18 months. Sprays after surgery reliably reduce this risk.

Will the sense of smell return?

After surgery, smell improves in about half of patients. The longer the sense of smell was absent, the more difficult it is to predict.

Why asthma and aspirin?

Polyps and asthma have a common mechanism of inflammation. If it becomes difficult to breathe after taking aspirin or other non-steroidal anti-inflammatory drugs, you should definitely tell your doctor.

Are nasal polyps cancer?

No, these are benign mucosal growths. But a one-sided polyp or a bleeding mass must be investigated.

How often are polyps in the nose?

In a study of more than 10 thousand patients of the Vienna ENT clinic, polyps were found in 1.84%. A quarter of them had large polyps, and a third had severe symptoms.

What is biological therapy?

Medicines that block certain links of inflammation. They are prescribed for a severe course, when other treatment does not help.

09 / SOURCES

Sources

11 sources · reviews, guidelines and studiesShowCollapse

European Position Paper on Rhinosinusitis and Nasal Polyps 2020Rhinology, 2020doi:10.4193/Rhin20.600 ↗
Epidemiology of Chronic Rhinosinusitis: Prevalence and Risk FactorsJournal of Allergy and Clinical Immunology: In Practice, 2022doi:10.1016/j.jaip.2022.01.016 ↗
Adult chronic rhinosinusitisNature Reviews Disease Primers, 2020doi:10.1038/s41572-020-00218-1 ↗
Global Incidence and Prevalence of Chronic Rhinosinusitis: A Systematic ReviewClinical & Experimental Allergy, 2025doi:10.1111/cea.14592 ↗
Prevalence and Symptom Burden of Nasal Polyps in a Large Austrian PopulationJournal of Allergy and Clinical Immunology: In Practice, 2021doi:10.1016/j.jaip.2021.06.037 ↗
Chronic Rhinosinusitis with Nasal Polyps and AsthmaJournal of Allergy and Clinical Immunology: In Practice, 2021doi:10.1016/j.jaip.2020.09.063 ↗
The Joint Task Force on Practice Parameters GRADE guidelines for the medical management of chronic rhinosinusitis with nasal polyposisJournal of Allergy and Clinical Immunology, 2023doi:10.1016/j.jaci.2022.10.026 ↗
Topical steroids for nasal polypsCochrane Database of Systematic Reviews, 2012doi:10.1002/14651858.CD006549.pub2 ↗
Short-course oral steroids alone for chronic rhinosinusitisCochrane Database of Systematic Reviews, 2016doi:10.1002/14651858.CD011991.pub2 ↗
Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposisLaryngoscope, 2017doi:10.1002/lary.26391 ↗
Surgery for chronic rhinosinusitis with nasal polyps: An updateEuropean Annals of Otorhinolaryngology, Head and Neck Diseases, 2023doi:10.1016/j.anorl.2023.10.008 ↗

The figures on the page are from these sources.

VALIKHNOVSKI SURGERY PARTNERS

The sense of smell has disappeared and
the nose does not breathe?

Describe the complaints and what has already been treated, or send a CT scan. The doctor will tell whether the sprays are enough or whether surgery is needed.

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