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.
A related discussion, Polyps and surgery
A related discussion, nasal polyps
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.
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?
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?