Aa
Aa
A
A
A
Close
Avatar universal

Research on Cause of nasal polyps

MDA
What is the latest research in effective treatments for chronic nasal polyps? What hospitals in the U.S. treat difficult, chronic, resistant cases?

Summary:
40 yr male. Over the past 6-7 years, I've had FESS 4 times, including turbinate reduction and deviated septum correction the first time, and in-office microdebridement of polyps 4 times.

Polyps always return. Nasal steriod sprays ineffective. Antifungal rinses ineffective. Daily saline nasal rinse ineffective.

I prefer to avoid further surgeries since they treat the polyps instead of the underlying cause of the polyps.

Only effective long term treatment has been prednisone. I have taken 10-20mg daily for 2 years and bone density scan indicates very early osteoporosis so rheumatologist has prescribed Fosamax and calcium supplements.

Details:
I want to discontinue steriod use, but attempts to decrease dosage result in polyps quickly returning, resulting in bilateral nasal blockage, thick golden discharge, and no smell (anosia??).

Skin allergy testing indicated allergies to cats (none in home), two types of fungus (alternaria and one other), and another item. Personal experiments indicate allergy to high fructose corn syrup. I discontinued consumption of sweetened sodas three years ago and only consume water or iced tea sweetened with Splenda.

A blood panel for common food allergies negative (basic LabCorp food panel).

Have tried over the past 5 years:
steroid nasal drops (decadron in solution)
amphoteracin nasal rinse for 6 months
Singulair tablets crushed in saline as drops

I do not feel my local doctors (have seen two ENTs) are able to help me. I am now dependent on prednisone to be able to breath freely and have a limited sense of smell.

I am willing to travel in the U.S. if it will get me the help I need. I live in the greater Raleigh, NC area.

What steps can I take? I feel desperate to get off systemic steroids.
7 Responses
Sort by: Helpful Oldest Newest
242588 tn?1224271700
MEDICAL PROFESSIONAL
This is tough.  What often works is surgical removal, followed almost immediately by nasal steroids.  That is a time when, with the polyps out of the way, the inhaled steroid can be well distributed over the nasal mucosa and is ever so much more effective than when the polyps are still there.  I trust that you do not use aspirin or any related medicines, such as ibuprofen.

If your polyps are on an allergic basis, anti-leukotriene medicines, taken orally, are often helpful.  Finally, although not an official indication, Anti-IgE therapy might work, especially if your serum IgE is highly elevated.

The National Jewish Medical and Research Center in Denver, Colorado would be a good place for you to request consultation.
Helpful - 1
Avatar universal
A related discussion, Successful treatment of nasal polyps was started.
Helpful - 0
Avatar universal
A related discussion, Polyps and surgery was started.
Helpful - 0
Avatar universal
A related discussion, nasal polyps was started.
Helpful - 0
Avatar universal
MDA
Thank you for your reply.  After doing a lot more reading of articles online, I've scheduled consultation appts at both Duke (which is close to home) and up at Johns Hopkins in Baltimore.

I will do more research on the IgE - I'm not familiar with that. I feel I need to become better educated so I can better understand my options and their risks.

I appreciate this q/a forum. It is a valuable resource.

Regards,
MDA
Helpful - 0
Avatar universal
MDA
I've been doing a lot of internet reading and have some more questions:

- Have any drugs used for rheumatoid arthritis proven effective in treating chronic nasal polyps? From my reading it sounds like prednisone is used in treating RA, so maybe, it seems to me, other drugs that work in RA would work for polyps?  What about methotrexate or an anti-malarial like chloroquine?

- Would it be reasonable to use a steroid rinse instead of just a steroid spray? I'm unsure that steroid sprays actually reach far enough in the sinus cavities to affect the polyp growth. Maybe a rinse followed by inverting my head for a while would be more effective without the side effects of consuming a steroid?   Have any studies been done on this?

- It seems drops would be more effective than sprays.  Have any studies indicated this?  What about using a common spray (flonase, nasarel, rhinocort, etc.) but as a drop?

My reading is indicating that there isn't much known about how to treat my condition beyond surgery and systemic steroids. Johns Hopkins and Jewish Medical seem to be the two primary research institutions involved in nasal polyposis. Is that accurate and are there others?

Regards,
MDA
Helpful - 0
Avatar universal
MDA
Another question:
In other answers, I've seen references to "the root of the polyp" and a suggestion that if the root is removed, a polyp will not regrow.

Does radio guided FESS result in the root being removed? If so, does radio guided surgery result in a lower rate of polyp recurrence?

My understanding is polyps high in the sinuses are dangerous to completely remove due to proximity to eyes and brain. If so, how can the roots of those polyps be removed?

MDA
Helpful - 0

You are reading content posted in the Asthma and Allergy Forum

Didn't find the answer you were looking for?
Ask a question
Popular Resources
Find out what causes asthma, and how to take control of your symptoms.
Find out if your city is a top "allergy capital."
Find out which foods you should watch out for.
If you’re one of the 35 million Americans who suffer from hay fever, read on for what plants are to blame, where to find them and how to get relief.
Allergist Dr. Lily Pien answers Medhelp users' most pressing allergy-related questions
When you start sniffling and sneezing, you know spring has sprung. Check out these four natural remedies to nix spring allergies.