Allergy, Nose & Sinus

What are nasal polyps? (Warning – Graphic Medical Images And Video)

February 1, 2020
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What are nasal polyps?

 

Nasal polyps (Figures 1) are growths or swellings from the lining (mucosa) of your nose and sinuses. Majority of polyps are due to chronic  sinusitis (long standing inflammation of the sinuses). However, sometimes, nasal polyps can be due to a tumour,  which most of the time is benign (non-cancerous) and rarely malignant (cancerous).

 

 

Figure 1 – Nasal polyps in the nose and sinus cavity

 

 

What are the symptoms of nasal polyps?

 

The symptoms of inflammatory nasal polyps are similar to those of chronic sinusitis. Patients may experience a blocked nose, runny nose (which may be clear or coloured), facial pressure or pain, reduced or loss of sense of smell and postnasal drip. Often, patients with reduced or loss of sense of smell will complain of loss of taste.

 

 

How are nasal polyps diagnosed?

 

An ENT Specialist will perform a nasoendoscopy (a scope through the nose done under local anaesthesia in the clinic) in patients with symptoms suggestive of nasal polyps. Nasal polyps can be seen during a nasoendoscopy (Figures 2a-d). If the polyps has a “peeled grapes” appearance and are present in both sides of the nasal cavity, it is likely an inflammatory polyp. If the polyp has suspicious features (e.g. fleshy, bleeds easily or is present only on one side of the nasal cavity) additional tests such as a biopsy (extraction of a small sample of polyp tissue for analysis under the microscope) and a CT scan (special series of X-rays) may be required.

 

 

Figure 2a – Right nasal polyp

 

 

Figure 2b – Left nasal polyp

 

 

Figure 2c – Typical “peeled grape” appearance of a large inflammatory right nasal polyp completely blocking the right nasal cavity

 

 

Figure 2d- A large left nasal polyp almost coming out of the nose

 

 

What causes nasal polyps?

 

We do not know exactly why some people have polyps but certain risk factors such as chronic or recurrent sinus infections, allergies, chronic inflammation due to asthma and genetic factors may play a role in the formation of inflammatory polyps.

 

 

How are nasal polyps treated?

 

The symptoms of inflammatory nasal polyps can be reduced with medications (nasal steroid sprays, nasal wash, oral steroids and when acutely infected, oral antibiotics). However, in most patients, medications alone may not be adequate and sinus surgery (aka Functional Endoscopic Sinus Surgery or FESS) may be required. A recent study has shown that patients with chronic sinusitis with nasal polyps are more likely to fail medical treatments and require sinus surgery compared to patients with chronic sinusitis without nasal polyps.

 

The purpose of sinus surgery is to remove the polyps (to reduce the “inflammatory load”), unblock and drain the sinuses and allow application of medications (e.g. steroid solutions) into the sinuses to keep the polyps under control. If you also have Asthma or Bronchitis, it is important to treat your nasal polyps to prevent or minimize exacerbations of these lung conditions. Patients with chronic rhinosinusitis with nasal polyps have a higher chance of disease recurrence compared to those without nasal polyps. However, with regular follow up  early recurrence can be picked up and controlled with appropriate intervention and medications.

 

 

What are the potential complications of untreated nasal polyps?

 

Most of the time, nasal polyps are benign and do not lead to complications if left untreated. However, the symptoms and recurrent sinus infection from nasal polyps can significantly impair the quality of life of the patient.

 

Occasionally, untreated severe nasal polyps can lead to the following complications:

 

  1. Recurrent sinus infections
  2. Mucocoele formation – This refers to a bag of trapped mucous in a sinus that can potentially expand and erode into nearby critical organs such as the eyes and the brain.
  3. Mucopyocoele – This refers to an infected mucocoele (see video below)
  4. Severe sinus infection spreading to the eyes or brain
  5. Obstructive sleep apnoea (this is a condition in which one stops breathing momentarily during sleep)
  6. Worsening of inflammatory lower airway diseases such as Asthma and Bronchitis

 

Best wishes,

 

 

Dr Gan Eng Cern
ENT Specialist Singapore

 

When Should You See An ENT Specialist In Singapore?

  • Any Ear, Nose or Throat symptoms that you are troubled with or concerned of
  • Persistent blocked nose with mouth breathing or snoring

Dr Gan Eng Cern

Dr Gan Eng Cern is a fellowship trained Consultant Ear, Nose & Throat (ENT) Surgeon. He completed his ENT training in Singapore and obtained his subspecialty training in Rhinology and Endoscopic Skull Base Surgery at the world renowned St Paul’s Sinus Centre, University of British Columbia, Vancouver, Canada. He was also a Senior Clinical Lecturer at Yong Loo Lin School of Medicine at the National University of Singapore. Dr Gan was an avid researcher with numerous publications in reputable international ENT journals. He was also an invited speaker and surgical dissection teacher in many ENT conferences and courses.

Awards

  • 2020 – Reader’s Choice Gold Award for Best ENT Specialist
    (Expat Living Singapore)
  • 2016 – Best Educator Award (Eastern Health Alliance)
  • 2016 – “Wow” Award (Patient Compliment)
  • 2014 – Eastern Health Alliance Caring Award – Silver
  • 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College
    of Surgeons, Academy of Medicine Singapore for best scientific surgical
    paper)
  • 2012 – Human Manpower Development Award (Ministry of Health,
    Singapore)
  • 2007 – Singhealth Best Doctor Award

Qualifications

  • MBBS - Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
  • MRCS (Edin) - Member of the Royal College of Surgeons Edinburgh, United Kingdom
  • MMed (ORL) - Master of Medicine in ENT (National University of Singapore)
  • FAMS - Fellow of the Academy of Medicine Singapore

Why Choose Dr Gan Eng Cern

1

Reliable & Reputable ENT Expert

Experienced and patient ENT Specialist who has your best interests at heart. We aim to provide you with accessible and specialized care for any ENT condition in a comfortable setting.

2

Friendly & Helpful Clinic Staff

Our friendly staff will assist you to the best of our ability and we are happy to accept most insurance providers and assist with E-filing with relevant insurance providers or Medisave.

3

Advanced ENT Equipment & Fully Equipped Facility

Our ENT Specialist, Dr Gan Eng Cern, will be able to diagnose and offer personalised treatments for your specific ENT condition. You can expect a high level of ENT care in a spacious setting with in-house minor surgical, endoscopy, allergy testing and microscopy services.

4

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There are various financial options available for you to ensure that you are able to receive the most optimal treatment and care. Our ENT clinic staff will be able to assist you with your medical insurance claims and work with your chosen healthcare organization to minimize the hassle and paperwork required. In some cases, you may be able to utilise the funds in your Medisave account to defray part of the costs of your treatment. As our clinic is accredited by the Medisave board, we are able to process your claims from your Medisave for certain clinic procedures.

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