Nasal Polyps: Possible Explanation For Cold Symptoms That Won't Go Away

Chronic sinusitis is like having a cold that won’t go away. A common medical condition, it’s defined by symptoms that last 12 weeks or more, including facial pressure, loss of smell, nasal drainage and trouble breathing through your nose.

Chronic sinusitis has several possible causes: infection, non-infectious inflammation, or the byproduct of a systemic issue such as cystic fibrosis or an autoimmune problem.

In some cases, chronic sinusitis can be caused by nasal polyps, which are benign growths that can block the sinuses and nasal cavities.

Symptoms Worsen With Polyp Growth

“About 25 percent of people with chronic sinusitis have polyps,” says Kenneth Rodriguez, MD, Chief of Rhinology and Anterior Skull Base Surgery at University Hospitals.

The cause of nasal polyps is not completely understood, Dr. Rodriguez says, “but fundamentally, it is an inflammatory problem.”

Small polyps can be present and you might not notice them. As polyps grow, they descend out of the sinuses and block the nasal passages. This leads to loss of smell and nasal breathing issues, Dr. Rodriguez says.

“As the polyps grow, they cause progressive symptoms,” he says.

He urges sinus sufferers to start with over-the-counter remedies such as saline rinses and topical steroid sprays. Prescriptions are not required for these therapies and research demonstrates that they improve symptoms in patients with chronic sinusitis.

Ultimately, if over-the-counter therapy does not help, prescription medication should be considered. This can be provided through a primary care provider or an otolaryngologist. In some cases, particularly with individuals with polyps, surgery may be required if medical therapy does not provide enough benefit.

“If polyps completely fill the nasal cavity, a spray can’t get to the roots,” he says. “If you have space in the nasal cavity, sprays will work better by being able to cover more of the surface area of the polyps.”

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 (CT) 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. It’s 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.”

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Chronic sinus infections, allergies and nasal problems are frustrating and can lead to a significant decrease in quality of life. Your symptoms may include altered smell or loss of smell, nasal breathing issues, nasal drainage or facial pain or pressure issues, problems that can significantly affect your day-to-day ability to function. The board-certified ear, nose and throat doctors at University Hospitals have the skill and expertise to diagnose and treat acute and chronic nasal and sinus conditions, as well as more complex issues. Learn more about nose, sinus and allergy services at UH.