Nasal polyps, how big is too big?

[chucky96]

I have cronic sinusitis caused by years of worsening allergic rinitis.  After some health problems and many tests including an EKG, chest X-ray, CT, and MRI, they found I have multiple bilateral polyps in my maxillary sinuses.  The largest of which is 2.3CM on the left and 2.9CM on the right.  My doctor sid these are SMALL polyps.  I personally think that anything over an inch in diameter in my head that should not be in my head, is pretty big.  I have been put on nasonex, for almost 2 weeks and have noticed NO improvement to my symptoms(dull headache, dizziness, feeling of pressure on the maxillary bone and septum).  There are multiple polyps on each side and I think that my maxillary sinuses may not have much room left.  My doctor said he doesnt think surgury is going to be nessecary.  So my question is:  What is considdered a large polyp?  Can you give me a size range in CM for a normal human being?  Does my case sound like a candidate for surgury and should I go back to my doctor and ask him to remove the polyps?

[National Jewish]

Nasal polyps are fleshy growths of the lining of the nose and sinuses.  Their roots are found in the upper part of the nose and in the ethmoid and maxillary sinuses.  On a sinus x-ray they may look like clouding of the ethmoid and maxillary sinuses.  A developing polyp is teardrop-shaped.  A mature polyp looks like a peeled seedless grape.  They can get large enough to block the opening of the sinuses and the nasal passage.  However the size is irrelevant since they are soft tissue growths so they are easily compressed.  You could certainly be feeling this as a dull headache, dizziness, and a feeling of pressure on the maxillary bone and septum.  When nasal polyps block drainage from the sinuses they can lead to chronic sinusitis.  Surgery to remove the nasal polyps may be suggested since this is the only way to get rid of chronic sinusitis.  Although it is impossible to say if the nasal polyps will grow back, this is a common occurrence.

It’s common to be treated with medicine before surgery is considered.  A prescription nasal steroid spray, like the Nasonex® (mometasone) that you have been using, can shrink nasal polyps over time.  A nasal steroid spray does not provide immediate relief of symptoms.  It may need to be used every day for several weeks to months to notice improvement in your symptoms.  A nasal wash helps remove mucus from your nose and sinuses.  It is most helpful when done daily before using any nasal spray.  Please read our nasal wash treatment information at http://www.nationaljewish.org/disease-info/treatments/alt-ther/nasal-wash.aspx to learn more about this technique.  Share this information with your doctor to see if you would benefit from this daily treatment.

If the nasal polyps are small this may be all the treatment that is needed to relieve your symptoms.  If they are large, this treatment may shrink them enough that surgery is more likely to remove the entire root of the polyp so that it doesn’t grow back.  Following surgery, indefinite routine use of a nasal steroid spray may keep nasal polyps from growing back.

Sometimes in addition to a nasal steroid spray, nasal polyps are treated with oral steroids for a short period of time.  Like the nasal steroid spray, they will shrink the nasal polyps.  However oral steroids are stronger than nasal steroid sprays, so greater benefit may be seen sooner.  Talk with your doctor about these options.  A second opinion is often a good choice just to see if the recommendation is the same.

[jaypetch]

Hello my name is Jay and I am a profesional vocalist/ flutist.
I have been dealing with an ongoing iritating mucose, pharynx problem and would be so apreciative if anyone could shed some bright light on the situation.
I have been living with clear, thick and sticky mucose being produced and sliding down the back of my sinus along the pharynx and finally ending up in my chest. I do have a slight bent septum (sinusitis) but ENTs and doctors have said that it’s not worth surgery to correct it.
The main problem that I am confronted with is the sensitivity that I experience around my oral pharynx in my oral region (uvula and soft pallet tonsils) from this mucose scraping off mucose membrane. Unfortunately as I talk it scratches and as I sing it does the same thing, even when I eat the sensitivity drives me crazy.. The feeling is like the mucose is wasing acid over my lining and continually making all these areas sensitive. It also seems to be a drying scratchy feeling
Tonsils look similar to blisters and feel irritated on and off.
I also get glands poping up under my tongue and in the side of neck.
any sort of exercise or vigorous exertion tends to irritate the areas as well, (dryes out quick and then irritated.)
I have put my career on hold as singing and talking is irritating 90% of the time and life is depresing because of this.
Any info would be invaluable as I am running into dead ends and get the ongoing reply from GPs and specialists that I will have to live with it.
This has now become my life investigation for over 2 years and I realy beleive that some one out there could help me.
Jay

[Melross]

In January my daughter had a polyp removed from her left maxiallary sinus.  It was discovered after I noticed something hanging down the back of her throat and she was suffering from sleep apnea.  The ENT said it was 6 inches long and about the size of an oyster at the root. (YUK.) She had a miserable sinus infection in August that took 2 courses of antibiotics to get rid of.  She had pain in her left nostril and sinus last week, a bloody nose on that side 2 days ago.  Began having trouble swallowing, looked in her throat and saw something hanging behind her uvula. Yesterday she had blood all down the back of her throat, but couldn't see anything else. Brought her to the pediatrician, can't see anything and does a strep test.  Can't explain the bleeding, gives me steroid nasal spray.  I made an appointment with ENT on my own.  I think this sounds like another sinus infection or another polyp.  It can't be normal to have that much blood running down your throat-I mean, there was ALOT.  Has anyone else had anything like this?  Thanks for any help.

[cookco]

I have had at least 6 surgeries for removal of nasal polyps. I have learned a lot during the last 20+ years.

First what causes the polyps are sinus infections. So the key is to avoid the infections. When i would get a cold  i would always get an infection. I also had to find out what i was allergic so that it can be treated. I am getting allergy shots, i do the sinus irrigation and streoids sprays.

My last surgery was May 04. So far no polyps have returned. This is the longest I've gone without polyps after surgery. I was on the Nasonex spray, but my allergist instructed me to stop the Nasonex  and use the inhaler Flovent for the nose. It is ment for inhaling but you modify the opening by placing a baby bottle nipple on it and cutting the tip so that it can be used for the nose. He said that this has the same ingredients as Nasonex but in powder form. Since Nasonex is liquid it simply drips away, the powder sticks around longer. I just saw the doctor this week, polyps have not returned, the Flovent is working. I can smell and taste, and my allergies are under control.

I just got over a cold, no sinus infection. During the cold i was irrigating with the water pic with an adapter for the nose. I have to say that whenerver I use to get a cold I always lost my sense of smell and couldn't breathe. Throught this cold i was able to smell and everything was basically clear. I was able to avoid a sinus infection by flushing everything out.

[caz643]

A related discussion, Have I a nasal polyps was started.