Our Summary

This research paper explores what might cause the formation or growth of nasal polyps in people with chronic rhinosinusitis (CRS), a long-term inflammation of the upper airways. Scientists know that normal nasal tissues can turn into polyps over time in people with CRS, but they’re not sure why. In this study, the researchers compared the immune responses of polyps and nearby normal tissue in 10 CRS patients, as well as normal nasal tissue in 10 people who were having pituitary surgery for other reasons. They found that both the polyps and nearby normal tissue in the CRS patients had similar immune responses, which were different from the responses in the control group. When they exposed the polyps to a particular bacterium, the polyps’ immune response was skewed toward two specific pathways. The researchers suggest that this skewed immune response might allow bacteria to survive and create a long-term inflammatory environment, which could then lead to the formation of new polyps or the recurrence of polyps after surgery.

FAQs

  1. What is chronic rhinosinusitis (CRS) and how is it related to nasal polyps?
  2. What did the study find about the immune responses in polyps and normal tissue in CRS patients?
  3. How might the skewed immune response contribute to the formation or recurrence of nasal polyps?

Doctor’s Tip

One helpful tip a doctor might tell a patient about nasal polyp removal is to follow post-operative care instructions carefully to prevent infection and promote proper healing. This may include keeping the nasal passages clean, avoiding strenuous activities, and using any prescribed medications as directed. It is also important to attend follow-up appointments to ensure proper healing and monitor for any signs of recurrence. Additionally, maintaining good nasal hygiene, such as using a saline nasal rinse regularly, may help prevent future polyp growth.

Suitable For

Patients with chronic rhinosinusitis (CRS) who have nasal polyps that are not responding to medications or causing severe symptoms such as persistent nasal congestion, difficulty breathing, loss of smell or taste, frequent sinus infections, and facial pain or pressure may be recommended nasal polyp removal. This procedure is typically considered when other treatments, such as corticosteroid nasal sprays, antibiotics, or nasal irrigation, have not been effective in managing the symptoms.

Nasal polyp removal may also be recommended for patients who have complications related to their nasal polyps, such as chronic sinusitis, asthma, or sleep apnea. In some cases, nasal polyps may obstruct the nasal passages to the point where breathing becomes difficult, and surgery may be necessary to alleviate the obstruction and improve airflow.

It is important for patients to discuss their symptoms and treatment options with an otolaryngologist (ear, nose, and throat specialist) to determine if nasal polyp removal is the best course of action for their individual case. The decision to undergo nasal polyp removal surgery should be based on a thorough evaluation of the patient’s medical history, symptoms, and overall health, as well as the potential risks and benefits of the procedure.

Timeline

Before nasal polyp removal:

  1. Chronic rhinosinusitis (CRS) develops in the patient, leading to inflammation of the upper airways.
  2. Over time, normal nasal tissues can turn into polyps in some patients with CRS.
  3. The patient may experience symptoms such as nasal congestion, difficulty breathing, loss of smell, and facial pain or pressure.

After nasal polyp removal:

  1. The patient undergoes nasal polyp removal surgery to alleviate symptoms and improve breathing.
  2. Recovery from the surgery may involve discomfort, swelling, and congestion for a period of time.
  3. As the nasal passages heal, the patient may experience improved breathing, reduced nasal congestion, and a return of sense of smell.
  4. Follow-up appointments with the healthcare provider are necessary to monitor for any recurrence of polyps and to ensure proper healing.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with nasal polyp removal surgery?
  2. How long is the recovery period after nasal polyp removal surgery?
  3. Will I need to take any medications or follow any specific post-operative care instructions?
  4. How likely is it that the nasal polyps will recur after surgery?
  5. Are there any alternative treatment options for nasal polyps that I should consider?
  6. Will I need to undergo any further testing or follow-up appointments after the surgery?
  7. What are the expected outcomes of nasal polyp removal surgery in terms of symptom relief and quality of life improvement?
  8. How experienced are you in performing nasal polyp removal surgery?
  9. Are there any lifestyle changes or precautions I should take to prevent the recurrence of nasal polyps after surgery?
  10. Can you explain the potential role of immune responses in the formation or growth of nasal polyps, based on current research findings?

Reference

Authors: Biggs TC, Hayes SM, Harries PG, Allan RN, Walls AF, Pender SLF, Salib RJ. Journal: Rhinology. 2019 Oct 1;57(5):336-342. doi: 10.4193/Rhin19.167. PMID: 31317972