Question: I have a diagnosis of a nasal polyp of the left nasal passage. I scheduled for a CAT scan and was told will probably need surgery. Most comments from patients who have had this type of surgery have very negative about post-op comfort and length of recuperation. Are there different surgical procedures which would result in less negative feedback? How frequently do nasal polyps grow back requiring repeat surgery?
Answer: First of all, thank you for your question. Nasal polyps are growths in the nose and sinuses that can block both the bleeding and the sinus openings. This can make breathing through the nose difficult, exacerbate asthma and lead to chronic or recurrent sinus infections. We try to get the nasal polyps to shrink down medically so that the symptoms improve. If we are successful then the surgery is not usually necessary. However, when the symptoms persist we do recommend endoscopic sinus surgery as an adjunct to ongoing care. Nasal polyps are frequently caused by allergies but can also be caused just by other recurrent infections or sensitivities. Unfortunately, surgery does not cure the underlying problem and polyps can recur. Postoperative care is quite important to lessen this possibility.
Today, endoscopic sinus surgery is done with minimally invasive techniques. We almost never use packing in the nasal passages today. Often, we can use balloon sinuplasty to open the sinuses which is much less invasive than other techniques. The procedures are done with image guidance- sort of like a GPS for the sinuses- which allows us to see real-time where we are on your CT scan- with submillimeter precision. We are using drugs including stents after surgery in many patients which further improves their course. With such techniques, most patients do not really complain of much pain after surgery.
We would be happy to see you at the New York Sinus Center and review what your options may be.
I hope this clears things up.
Robert L. Pincus MD
Co-director New York Sinus Center
Frequently Asked Questions
Nasal polyps are growths in the nose and sinuses that can block airflow and sinus drainage. This blockage makes breathing through the nose difficult and can worsen asthma symptoms while leading to chronic or recurrent sinus infections.
Yes, doctors usually try to shrink nasal polyps medically first to improve symptoms. If the polyps respond well to medication, surgery may not be needed. However, persistent symptoms after medical treatment often lead to recommending endoscopic sinus surgery.
The most common surgical approach is minimally invasive endoscopic sinus surgery, often supplemented with balloon sinuplasty to open the sinuses less invasively. These procedures use image guidance for precision and typically avoid nasal packing, improving patient comfort and recovery.
Modern sinus surgery techniques are minimally invasive, use real-time image guidance for precision, and rarely require nasal packing. Additionally, post-operative care including medications and sinus stents helps improve healing, leading to less pain and faster recovery for most patients.
Yes, nasal polyps can recur because surgery does not cure the underlying causes, such as allergies or sensitivities. Proper postoperative care is critical to lower the chances of recurrence and manage ongoing symptoms effectively.
Allergies are a common cause of nasal polyps, although recurrent infections and sensitivities may also trigger their formation. Managing these underlying conditions is an important part of overall treatment to control polyp growth.
Image guidance acts like a GPS for the sinuses, providing submillimeter precision and real-time navigation based on CT scans during surgery. This technology enhances surgical safety and effectiveness by allowing the surgeon to see exactly where they are operating.
