Sinonasal Tumors / Polyps / Masses

Insight into treating a runny nose

Sinonasal Tumors/Polyps/Masses

Nasal polyps are pink, watery-appearing growths that occur within the nose and sinuses. They look like blisters of the tissue and when removed may look like small grapes. Polyps are sometimes seen in conjunction with allergies or sinusitis. They range in size from very small swellings that do not cause much trouble and sit on the outer ways of the sinuses. Other polyps may grow in key drainage points and even though small can lead to critical blockage. Larger polyps can completely fill the nasal cavity and be visible from the nostrils.

Sinus and nasal polyps are not like polyps in other parts of the body, such as the colon (large intestine). They are almost always benign and not a precursor to cancer. However, there are growths in the sinuses and nose that may look like polyps but can be precancerous or very rarely actually contain cancer. These masses are often on one side of the nasal cavity only, while most true benign nasal polyps are present in both sides. Polyps present in one nasal cavity but not on the other, should be biopsied or removed if they are suspicious.

A wart-like growth that looks similar to a polyp is called an inverted papilloma. These are most often benign, but do not respond to medications like steroids as being nasal polyps do. About 10% of inverted papillomas may be associated with sinus cancer.

What causes nasal polyps?

The exact cause of benign nasal polyps is unknown at this time. There are multiple factors that may contribute to the growth of nasal polyps. They often represent the final result of chronic inflammation. Allergies may contribute to their growth by causing chronic inflammation of the tissues. Patients with fungal sinus infections often have severe allergic reactions to the fungus and their sinuses may have the most extensive polyps.

Patients with asthma, which causes problems with the linings of the breathing passageways, are known to have a higher probability of having nasal polyps also. A hereditary component or cause for polyps may also be suspected in some patients. As an example, some cystic fibrosis patients have nasal polyps. In general, nasal polyps seem to occur more frequently in those with affected family members.

What are the symptoms for sinusitis?

Major symptoms of a sinus infection include facial pain or pressure. Sinus pain and pressure is caused by pressure on the nerves of the sinuses by the swollen and irritated tissues. If polyps or fungus are involved there is often less pressure and pain compared with acute bacterial infections. Negative pressure vacuum of the sinuses can be caused by blockage of the sinus ostia and this can also result in the symptom of pain and pressure.

Other major symptoms that may be noted are nasal stuffiness or fullness and pus draining from the front of the nose or down the throat. Many will also notice difficulty with the ability to smell and even changes in their taste. Swollen nasal tissues and increased or thickened nasal sections often cause difficulty breathing through the nose. Some patients will also snore due to this blockage. Other factors evaluated in the diagnosis of sinusitis include headache and bad breath, fatigue, cough, dental pain and in the case of acute infections, fever. The bad breath is due to the presence of bacteria in the thick mucus that may drain into the throat from the back of the nose during sinusitis.

How do I tell the difference between a cold and sinusitis?

It can be difficult to distinguish between a having a cold and having sinusitis. Colds are caused by common viruses. Your body's natural defenses can usually fight off these in about a week. However, sinusitis typically has a more protracted course and the symptoms will persist beyond 5 to 7 days. In fact, sinusitis often will follow or complicate a cold it's like a cold that does not go away. There may also be differences in appearance of the mucus draining from the nose. Many of the over-the-counter treatments available for a cold will also help lessen some of the symptoms of a sinus infection, but if bacteria or fungus are present in infection-level quantities, symptoms will continue and medical attention is needed.

Content courtesy of AAO American Academy of Otolaryngology

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