Is it possible to cauterize a bleeding polyp in the nose. Benign tumors of the nose

Any chronic source of bleeding in the body is a serious problem. A bleeding nasal septal polyp is one such problem; this is a relatively independent pathology of the ENT organs (“comparatively”, since the International Classification of Diseases does not provide for a separate nosological unit for its designation), which has not been sufficiently studied at the moment.

It has been established, however, that pregnant women suffer from bleeding polyps more often than other categories of the population.

Such a neoplasm, by its histological nature, refers to benign tumors of the angiofibromatous type, i.e. consists of cells of vascular and fibrous connective (fibrous) tissues. However, the pathomorphology may vary, according to which the names “cavernous angioma”, “papillomatous fibroma”, etc. are also found in the literature. Outwardly, a polyp of this kind looks like a rounded, mushroom-shaped or papillary formation, usually purple-red, sometimes with a cyanotic tinge, on a more or less isolated stalk.

It is always located on one wall of the nasal septum and can quickly increase in size, although the tendency to grow into adjacent tissues and, in general, to malignant process for an angiofibromatous polyp is not typical.

2. Reasons

The close statistical association between pregnancy and the incidence of bleeding nasal polyps logically implies the presence of a causal relationship - which, however, has not been confirmed to this day (the assumption of the influence of hormonal changes in itself explains little).

As a direct etiopathogenetic factor, the activity of HPV (human papillomavirus, hence one of the synonymous names, see above), the provoking effect of microtraumas, the presence of chronic inflammation of the mucous membrane of the nasal septum, etc. is also considered. All of these competing hypotheses need further research and convincing justification.

3. Symptoms and diagnosis

As follows from the definition, an angiofibromatous polyp of the nasal septum is usually the cause of frequent bleeding, which can occur both spontaneously and when exposed to mechanical factors, even minor ones (light touch, sneezing, blowing your nose, etc.). Like other hemorrhages not provided for by nature, with prolonged existence of a polyp, bleeding leads to anemia. In addition, the upward trend quickly leads to impaired nasal breathing and olfactory sensitivity (hyposmia), and when the polyp reaches a certain size, to complete obstruction of the air passage from the affected side, which, in turn, causes headaches, fatigue, irritability, disorders sleep and a general decline in quality of life.

The diagnosis, which in this case is not a difficult task, is established by anamnestic and rhinoscopy, during a standard examination of the ENT organs: the polyp is in direct visual access and looks quite specific. In some cases, however, a biopsy specimen is taken for histological analysis and the exclusion of tumors of a different nature.

4. Treatment

To date, the only effective way to treat a bleeding nasal septal polyp is its surgical removal, and together with the polyp, a small amount of submucosal tissues (up to cartilage) is removed.

Minimally invasive methods - thermal, laser, etc. - recently widely practiced in otorhinolaryngology to eliminate clinically similar neoplasms, are not indicated in the case of an angiofibromatous polyp, because they leave a high chance of recurrence.

There are two type of chronic rhinosinusitis depending on the predominance of neutrophils or eosinophils in the pathogenesis of the disease. Nasal polyps are observed mainly in the eosinophilic type of chronic rhinosinusitis, forming a separate subgroup of chronic rhinosinusitis in this nosological form.

nasal polyps are formed in the upper part of the nasal cavity in the region of the ostiomeatal complex and outwardly resemble a bunch of grapes. They consist of loose connective tissue, contain a lot of water, inflammatory cells, a small number of glands and capillaries, and are covered with various types of epithelium, but mainly with multi-row respiratory epithelium containing ciliary and goblet cells.

Eosinophils- the most numerous cells in polyps, but there are also neutrophils, mast and plasma cells, lymphocytes, monocytes, and fibroblasts. The predominant cytokine in nasal polyps is IL-5, which is associated with increased activity and prolonged survival of eosinophils. No explanation has yet been found as to why some patients develop polyps and others do not.

A clear increase in the incidence of nasal polyps was revealed in patients with Sumpter's triad (bronchial asthma, hypersensitivity to NSAIDs and nasal polyps).

In general populations the prevalence of nasal polyps is 4%; among patients with bronchial asthma, this figure reaches 7-15%, and in people with intolerance to NSAIDs - 36-60%. Epidemiological studies have not found a link between nasal polyps and allergies. In children with nasal polyps, cystic fibrosis should be excluded.

Clinical picture of nasal polyps is of great diversity. Polyps can be single or multiple, up to diffuse polyposis of the nose and paranasal sinuses. In the nasal cavity itself, polyps are rarely formed, they are mainly localized in the region of the anterior cells of the ethmoid labyrinth, where the inflamed mucous membrane is subjected to pressure. From here, under the influence of gravity, they grow in the direction of least resistance through the middle nasal passage, filling the nasal cavity.

nasal polyps- benign massive formations on a long or wide stalk, formed on the mucous membrane of the nasal cavity or paranasal sinuses due to the inflammatory process.

a) Clinical picture of polyps in the nose. Clinical manifestations include impaired nasal breathing due to nasal obstruction, mechanical anosmia, retention lacrimation, colorless viscous or purulent discharge from the nose, chronic nasopharyngitis, headache, snoring, nasal voice. In children with nasal polyps, due to dysplasia of the facial skeleton, the face takes on a characteristic appearance (wide bony nose, "frog face").

Chronic rhinosinusitis can develop due to obstruction of the openings connecting the paranasal sinuses with the nasal cavity. Polyps can form in one or all of the paranasal sinuses, even if they are not present in the nose.

Choanal polyps have a long stalk and usually form in the maxillary sinus. They can completely block the choana or nasopharynx.

b) Causes and pathogenesis. Immunohistochemical studies show that chronic rhinosinusitis with and without nasal polyps are two different diseases. In both cases, there is an increase in the number of neutrophils, T- and B-lymphocytes, NK-lymphocytes and mast cells. With polyposis, the number of eosinophils, plasma cells and macrophages also increases.

Biological markers. Acute rhinosinusitis: activation of lymphocytes. Chronic rhinosinusitis: pro-inflammatory cytokines. Polyposis: in addition to the above biological markers, there is also a high concentration of IgE and IL-5 of T-lymphocytic and eosinophilic origin, indicating a "self-stimulated" eosinophilic reaction.

It is also believed that eosinophils migrate from the epithelium into the mucus, where they dock with T-lymphocytes. During degranulation, cytotoxic cytokines, in particular the major basic protein, are released from eosinophils. The main basic protein binds to the elements of the fungus secreted by the nasal mucosa, forming the so-called horseshoes. The latter cause a toxic-inflammatory reaction on the surface of the epithelium, which is secondarily infected with bacteria.

Leukotrienes. The role of leukotrienes in the pathogenesis of bronchial asthma is undoubted, and in patients with rhinosinusitis and nasal polyposis, an increased level of these mediators was found.

Patients with intolerance to aspirin constitute a special group. Aspirin and other NSAIDs that inhibit cyclooxygenase interfere with the conversion of arachidonic acid to prostaglandins. This, in turn, leads to a relative overproduction of leukotrienes.

Staphylococcal superantigens. In nasal polyps (but not chronic rhinosinusitis), superantigens of staphylococcal origin have a modulating effect on the severity and prevalence of the disease.

Airways. The characteristic features of the inflammatory reaction with the prevalence of eosinophils in nasal polyps resemble the features of the inflammatory process of the bronchial mucosa. In both cases, an immune reaction develops with a predominance of type 2 T-helpers, and bronchial asthma is often combined with nasal polyps and aspirin intolerance. These facts make it possible to understand the danger of the spread of the inflammatory process from the upper respiratory tract to the lower ones in chronic hyperplastic rhinosinusitis.

in) Diagnosis of polyps in the nose. The diagnosis is made on the basis of a typical clinical picture revealed during anterior rhinoscopy: the presence of a single or multiple dull, translucent, whitish-yellow massive formations with a smooth surface, mobile during examination with a probe and usually localized in the middle nasal passage or choana. Polyps are usually bilateral. Of the other studies, nasal endoscopy, CT, determination of the level of C-reactive protein, cytological examination and allergological tests should be noted.

C-reactive protein is one of the acute phase proteins. The level of C-reactive protein is of diagnostic value in bacterial infection. However, in patients suspected of having an infectious disease, a C-reactive protein level of less than 100 mg/l makes it impossible to determine whether the infection is caused by bacteria, viruses, fungi, or protozoa.

P.S. With nasal polyposis, the formation of polyps is also often observed in the paranasal sinuses, so the latter should always be examined radiologically, and if possible, also endoscopically.

G) Differential Diagnosis. Encephalomeningocele (exclude by X-ray and probing), bleeding polyp of the nasal septum, malignant tumors of the nose, tumors of the pituitary gland (eg, adenoma).

e) Treatment of polyps in the nose. Treatment of polyposis is gradual, it begins with conservative therapy and, if ineffective, surgical intervention is performed. Given the pronounced tendency of polyps to recur, patients need to be monitored with the performance, according to indications, of endoscopic examination. Below are the recommendations of the European Academy of Allergology and Clinical Immunology on polyposis and sinusitis, as well as the principles of treatment set out in the memorandum on rhinosinusitis and nasal polyps.

Glucocorticoids for topical use. Because of their pronounced anti-inflammatory action, glucocorticoids (eg, mometasone, fluticasone) are considered the drugs of choice.

Antibiotics. In case of exacerbations, antibiotics are prescribed taking into account the sensitivity of pathogens to them (remember staphylococcal superantigens; empirical antibiotic therapy: amoxicillin in combination with clavulanic acid). There are no serious studies on the efficacy of long-term antibiotic treatment (available data are Level III and Grade C evidence).

Leukotriene receptor blockers. Controlled studies of the effectiveness of these drugs in rhinosinusitis and polyps have not been conducted. The results of a few case-control studies suggest a possible beneficial effect of leukotriene receptor blockers in reducing symptoms in patients with chronic persistent rhinosinusitis and nasal polyposis.

Deactivation by aspirin. Adaptive deactivation by long-term administration of aspirin 100 mg orally reduces the likelihood of relapse. The initial period of deactivation (the induction phase) must be carried out in a hospital.

e) Surgical removal of nasal polyps. Before surgery, it is advisable to carry out local treatment with glucocorticoids; in the perioperative period, methylprednisolone is prescribed (the initial dose of 125 mg is gradually reduced over 3 weeks until the drug is completely discontinued). Functional endoscopic interventions in the ethmoid and other paranasal sinuses depend on the results of endoscopy and CT. The range of surgical interventions is wide - from infundibulotomy to bilateral pansinus surgery (removal with a shaver).

The operation does not affect the cause that contributes to the mucosal immune response with a predominance of T-helper type 2, but it creates a favorable background for local treatment with glucocorticoids. A significant role is played by long-term anti-inflammatory treatment in the long-term period after surgery with endoscopic control.

Although nasal polyps shrink or completely disappear during treatment with glucocorticoids, such treatment cannot be considered effective, since after the abolition of glucocorticoids, polyps recur. If it is possible to identify the allergen, measures are taken to eliminate contact with it.

There is no specific information about the etiology of this disease. Since this disease occurs more often in women, its endocrine nature is suggested. There are other "theories", such as traumatic, inflammatory, oncological, but there is no reason to consider one of them more real than the others.

pathological anatomy

Macroscopically, a bleeding nasal septal polyp is a round tumor ranging in size from a small pea to a large cherry, dark red or bluish in color, papillary or mushroom-shaped, on a stalk, bleeding easily when touched, often bleeding spontaneously, especially when sneezing or blowing your nose. The density of the tumor is determined by the ratio of vascular and fibrous tissue.

The microscopic structure of a bleeding polyp of the nasal septum is diverse and is determined by the composition of the vascular and connective tissues, often the tumor also contains inflammatory elements such as granulation tissue. In foreign literature, due to the diversity of the histological structure of the bleeding polyp of the nasal septum, this tumor has received many names: inflammatory granuloma, angiofibroma, pure angioma, cavernous angioma, telangiectatic fibroma, papillomatous fibroma, etc.

A nasal polyp is an overgrowth of the mucous membrane protruding into the cavity or sinus of the nose. They arise as a result of benign changes in the mucosa. The curvature of the nasal septum, changes in the endocrine, immune, and nervous systems predispose to polypogenesis.

Causes of formation and symptoms of polyps

Mucous growths in the nose occur with polypous allergic rhinitis (runny nose) or rhinosinusitis. When the process spreads to all sinuses, the phenomenon of polyposis pansinusitis is simultaneously observed.

Types of polyposis

Allocate polyposis:

multiple; unit; deforming.

The causes of polyposis are considered allergens that enter the body from the outside, and auto-allergens produced by the body itself in response to infection. Autoallergens are formed in response to a malfunction of the immune system, which begins to perceive the nasal mucosa as a foreign tissue.

Mucosal changes

With frequent inflammations, traumatic irritations, the mucous layer changes its structure, the connective cells of the submucosal layer grow, fibrous degeneration of the polyp begins. The resulting polyp may resemble papilloma, adenoma, fibroma in appearance.

A polyp is a benign non-tumor formation that is not life threatening. Polyps never degenerate into malignant tumors.

Polyps are more common in adults. In children, this phenomenon is rarely observed. Symptoms of polyps include snoring during sleep, difficulty breathing through the nose, and frequent colds. The patient may suffer from frequent headaches, discharge from the nose.

With large growths that impede breathing, symptoms of oxygen starvation may be observed. The patient's health worsens, irritability appears, sleep is disturbed.

Formations can reach the size of a chicken egg, but more often they are small in size. They differ in growth rate, localization. Large polyps can be injured and bleed, and with a sneeze or blowing their nose, they come off and are removed.

Polyposis can be observed on one side of the face, mainly with the formation of polyps in the maxillary cavity or cells of the ethmoid bone. Bilateral polyposis occurs as a secondary disease of the atopic allergic process.

single polyp

A single (solitary) polyp always occurs only in adults. The place of its formation, as a rule, becomes the maxillary cavity, sometimes the ethmoid labyrinth or the sinus of the sphenoid bone.

Around the polyp formed in the maxillary nasal cavity, polyposis growths are noted, in the photo you can see the altered mucous tissue.

The growth of a solitary polyp can occur towards the nasal cavity or towards the nasopharynx.

With a large size, the polyp prevents free nasal breathing. Large growths cause a violation of the voice, lead to the appearance of a closed nasal.

With especially large polyps in the nose, irritation of the posterior wall of the nasopharynx is observed, which causes a gag reflex. Changes also apply to the auditory tube, its ventilation function is disturbed. As a result, there is stuffiness of the ear from the side of the polyp, hearing loss.

Multiple polyposis

The process of polyp formation can go on for a long time and lead to their multiple growth in the sinuses. Formations can spread to all sinuses of the nose, penetrate into the middle ear, auditory tube.

Deforming polyposis

It occurs in young people, has an infectious-allergic nature, there is a hereditary predisposition to the disease. Deformation of the nasal septum is observed in cases of insufficient treatment with the appearance of polyps in the nose up to 20 years.

The deformation of the nasal septum is caused by the pressure of growing polyps in children; in the photo of patients who have not received treatment, there is asymmetry of the nose and a change in its shape.

Symptoms of the formation of polyps in the nose are manifested in children by the inability to breathe through the nose, such a child is constantly with his mouth ajar. In childhood, this leads to such an unpleasant consequence as malocclusion.

The tissues of the bones of the skull, which have not been formed yet due to childhood, are deformed under the pressure of growing polyps, which causes a distortion of the outlines of the face, a visible violation of proportions.

The pressure of polyps in the nose and paranasal sinuses causes a violation of blood and lymph circulation, leads to venous stasis, which is accompanied by symptoms of hydrocephalus, dropsy of the brain. A sign of a polyp in the nose can be a complete lack of smell.

Loss of smell in deforming polyposis is irreversible.

Localization of nasal polyps

The appearance of polyps is caused by an increase in the general allergic sensitivity of the body, and their formation in the nose is caused by a weakening of the immunity of this particular organ. The approach to treatment depends on the nature of the process, there are:

Polyps in the nasal cavity, ethmoid labyrinth. The process is usually two-way. The nasal cavity, all the sinuses are filled with polyps, the septum is deformed, the nose as a whole looks asymmetrical. Polyposis is observed on both sides. A single polyp comes from the maxillary cavity, clogs the nasal cavity, disrupting nasal breathing. Marked on one side.

Polyposis is usually bilateral, excluding single formations. Unilateral growths in the sinuses of the nose can be symptoms of papilloma, cancer.

Diagnostics

Polyposis is diagnosed using histological examination and computed tomography. In order to properly prescribe treatment, the polyp is differentiated from other formations in the nose: myxomas, pedunculated adenomas, tumors.

Patients are tested for allergies and x-rays to detect growths in the paranasal sinuses.

Treatment

The treatment of polyposis is complex, it consists of treatment with antiallergic drugs and surgery. Therapeutic measures are based on the results of the examination of an allergist, a pulmonologist. Before the operation, a three-day course of prednisolone is prescribed.

Nasal polyp removal surgery

With a limited distribution of polyps in the nose and cells of the ethmoid bone, the operation is done with a polyp loop, microdebrider, Braxley forceps.

Removal of a polyp loop

The operation is performed under local anesthesia with lidocaine. The loop is introduced into the nasal passage, put on the body of the formation, gradually shifting to the leg. Then tighten the loop and cut off.

Removal with braxley forceps

Anesthetize locally with lidocaine. Under visual control, special Baxley forceps capture the polyp, trying to immediately capture its base, then remove it.

Removal with a microdebrider

Anesthesia is performed with lidocaine. The polyp is cut off with a microdebrider (shaver) - a tool equipped with a sharp blade that cuts the growth to the very base, and then sucks it up. When removed in this way, bleeding is possible, which is stopped by the introduction of a tampon or turunda.

Removal of multiple nasal polyps

With polypous pansinusitis, when all paranasal sinuses are filled with polyps, removal is done under general anesthesia. Before the operation, a computed tomography is required to determine the nature of the polyposis.

Polyposis is often observed with deformity of the nasal septum. In these cases, intervention begins with septoplasty - surgery to correct the shape of the nasal septum.

Then the cells of the ethmoid bone are cleared of polyps, penetrate into the posterior cells, and pass to the sinus of the sphenoid bone. Using a scalpel, the wall of the sphenoid sinus is perforated, expanded with forceps and penetrated into the cavity of the sphenoid bone.

Then, the growths of the mucous membrane are removed from the cells of the ethmoid labyrinth and the frontal sinuses are examined. The operation is completed by removing polyps from the maxillary sinus, removing them with Baxley forceps from the surgical wound. Having finished the operation on one side, perform the same actions on the other.

Endoscopic polypotomy

The method of endoscopic surgery can remove single polyps growing from the maxillary cavity, blocking the nasal passage, interfering with breathing.

The operation manages to completely restore breathing through the nose, but the cause that caused the disease is not eliminated in this way. After the operation, it is necessary to undergo antiallergic treatment, to establish the cause of polyposis.

The operation is performed under general anesthesia using an endoscope and a microdebrider. First, it is possible to eliminate the part that goes into the nasal cavity. Then the paranasal cavity from which the polyp grows is determined, and its remaining part is removed.

Usually it is necessary to remove the residue that fills the entire cavity from the maxillary sinus.

The operation for the removal of nasal polyps is a planned one. The patient is prepared in advance, treated, so there are practically no complications.

Removal of polyps with a laser

Removal of polyps in the nose with a laser is an endoscopic operation, performed under visual control. Refers to gentle methods. The procedure for removing a single polyp does not take more than 20 minutes, it is performed under local anesthesia.

The method of removing polyps in the nose with a laser is suitable for both single growths and extensive ones, the price of the operation depends on the degree of polyposis. Removal of a single polyp in the nose will cost about $300, laser treatment for severe disease is somewhat more expensive.

The operation is sterile, is not accompanied by bleeding, and is characterized by the absence of postoperative complications.

Endoscopic laser removal of nasal polyps is performed under visual control. The laser cuts tissues, through the incision the formations are evaporated with a beam, and the overgrown tissue is destroyed. After the operation, the patient is prescribed treatment with drugs, vitamins, inhalations.

Polyps may reappear after removal. To prevent relapse, the patient must undergo a diagnostic examination and follow the doctor's instructions. Flixonase spray is considered the best remedy for relapses.

The remedy for polyps should not be used as drops, in the form of a spray, the dosage in the nose is more accurately observed, the drug enters the mucous membrane in the form of tiny drops. A good effect on polyposis is provided by sprays aldetsin, avamys, nasobek, beclomethasone, beconase, benorin, rhinoclenil, nazarel.

You can use drugs under the supervision of a doctor, the funds help after surgery to remove growths. You should not try to use them instead of surgery, this may worsen the condition.

Treatment of nasal polyps without surgery

Often, after the removal of mucous formations by surgery, they reappear. This is explained by the fact that the operation does not eliminate the very cause that caused the appearance of the polyp.

Non-surgical methods of treating polyposis include procedures for washing the paranasal sinuses, saline inhalations, the action of ozone, a laser.

Physiotherapeutic methods for the treatment of nasal polyps allow you to do without surgery by improving blood and lymph circulation in the tissues, improving the condition of the mucosa.

Treatment with folk remedies

Giving preference to folk remedies for the treatment of nasal polyps, it should be borne in mind that the causes of mucosal growth are impaired immunity, allergies to various substances. Many medicinal plants in folk recipes can cause allergies and worsen the patient's condition.

When choosing a method for treating polyps in the nose with folk remedies, you need to focus not only on the reviews of other people, but also on the data of your own examination for allergens. You can start self-treatment of nasal polyps at home only after determining the examination by an allergist and identifying allergens that can cause a reaction.

It is useful to eat 2 handfuls of viburnum per day for a month. From this disease, they drink beet juice, settled for 3 hours in the refrigerator, carrots, with the addition of garlic onions. It is useful to do nasal lavage with saline, sea water. Oil of sea buckthorn, thuja, rosemary, St. John's wort is instilled into the nose with polyps.

Complications

The presence of polyps in the nasal cavity and paranasal sinuses cause complications in the respiratory system, causing bronchial diseases, provoking attacks of bronchial asthma. Polyps contribute to changes in the digestive system, causing bloating, aerophagia - swallowing air, followed by belching.

Among the complications of deforming polyposis, catarrhal, purulent otitis media, asthmatic bronchitis, cholecystitis, colitis, and pancreatitis are also noted.

Prevention

Prevention of the appearance of polyps consists in anti-allergic treatment aimed at reducing the body's sensitivity to allergens. Prevention includes treatment of sinusitis, ethmoiditis, timely elimination of foci of infection.

The patient should undergo a scheduled examination by an otolaryngologist several times a year and take supportive treatment.

Forecast

Prognosis is good with appropriate treatment

Nasal polyps are benign growths of the mucous epithelium. It is the presence of one or more pearl-gray jelly-like lumps.

Minor formations do not cause any problems, large ones tend to block the airways.

Based on this, they are visible, hanging from the nostrils, or not visible (if they are polyps in the sinuses), and special medical instruments are required to identify them.

The nose is a kind of natural and effective "filter" of every person: the villi of the inner surface of this organ remove over 80% of harmful particles, most of which are found in dust.

It settles around the anterior part of the middle of the turbinate, becoming the source of many ailments, the symptoms and treatment of which depend on a wide range of factors.

nasal polyps- these are abnormal outgrowths, or as they are also called - "excess meat in the nose" - should not be compared with polyposis, which is detected in the large intestine, bladder or urethra, since they are never malignant, therefore, the symptoms and treatment are completely different.

Nasal polyps: symptoms

You can suspect the presence of nasal polyposis by observing:

congestion and profuse runny nose; facial pain; reduced ability to smell (hyposmia) or its complete absence (anosmia); loss of appetite; eyelid itching.

Also, for many people, there is a risk of developing asthmatic syndrome, which develops symptoms such as wheezing, sensitivity to fumes, dust, and chemicals.

Types of polyps in the nose. Localization

There are usually two types - antrochoanal and ethmoid polyposis. The first originates from the antrum and upper jaw, grows towards the posterior respiratory passage, reaching the nasopharynx. Most often, this condition affects patients of the preschool-adolescent category.

Ethmoid benign neoplasms have different characteristics: they are bilateral, multiple, grow from the ethmoidal sinus, can appear at any age, and, given their always large size, are well visualized.

Causes of polyposis

Sometimes, the formation of a polypoid mass is preceded by a series of asthma attacks, but there are a number of other circumstances.

Among the predisposing conditions are: intolerance to aspirin; chronic sinus infection (polypous sinusitis develops); genetic factor (cystic fibrosis); hay fever and hereditary predisposition to varying degrees of polyposis.

Nasal polyps in a child: symptoms

Since breathing promotes the exchange of environmental air and lungs, it is not surprising that there is a certain risk of absorbing pathogenic environments that cause chronic inflammation in one breath.

Important information

Pollen, mold spores, animal hair, dust mites, solid particles of street dirt and many other substances can provoke inflammation of the mucous epithelium of the labyrinth.

Polyposis- the end result of a long-term lack of therapeutic measures in relation to these conditions, to which, due to their still weak immunity, children are more susceptible.

It can be quite difficult to identify these drop-shaped growths in them: it is not always clear to parents why children are restless, cry, refuse to eat, feel fear (in the event that the neoplasm completely or partially blocks the respiratory canal), suddenly become cyanotic.

The most common underlying cause of childhood polyposis is cystic fibrosis. Also among the dominant causes are chronic sinusitis, aspirin hypersensitivity syndrome and allergic or fungal rhinitis.

Growths appear near the maxillary sinus, with a tendency to spread to the nasopharynx. If they are barely noticeable, then they create minor problems in the form of snoring and mouth breathing.

Massive abnormal elements have a detrimental effect on children's health, since their presence is accompanied by a headache, as well as constant difficulties due to concomitant diseases of the ears and throat.

Why are nasal polyps dangerous?

Since the growths block the full flow of air and the outflow of natural secretions, there is a possibility of a number of aggravating circumstances.

Obstructive sleep apnea. This is a serious acute pathology, which is characterized by a complete short-term cessation of breathing at night, followed by its increase.

Asthma flare up.

The spread of the infectious process to the eyeball. If the inflammation spreads to the eyes, there is swelling or protrusion, puffiness, tearing, inability to look up and to the sides, decreased vision, or even blindness, which in rare cases becomes permanent.

Meningitis. One of the most critical phenomena that aggravate polyposis. With belated detection and lack of therapy, the pathogenic focus moves to the membranes, as well as the fluids surrounding the brain and spinal cord, infecting them.

Polyps in the nose: diagnosis

Medical practice shows that it is possible to make a diagnosis after receiving answers to some questions regarding the manifestations of the disease and complaints based on this; mandatory activities - general inspection and examination.

If the specialist sees relevance in conducting additional research methods, then the following are performed:

Endoscopy: Through an endoscope, a narrow tube equipped with a small camera (or magnifying glass), the patient is carefully examined. This method is not always effective, since it is sometimes difficult to identify small elements located deep in the cavity.

CT (computed tomography) scan: This specialized specialized equipment digitally processes an x-ray image from a variety of angles, then they are compared together to produce a 3-D image.

In addition, using this diagnostic method, the doctor identifies any other obstructions that prevent breathing.

Intradermal Allergy Testing: Small droplets of potential allergens are placed on a patient's skin scratch, usually on the patient's upper back or forearm. After 15 minutes, the health worker looks for signs of an allergic reaction - redness, itching, swelling.

Cystic fibrosis sweat test: If a child is sick, the doctor will order this genetic test, which measures the amount of sodium and chloride in a sample of sweat.

What do nasal polyps look like?

Treatment involves solving the primary problem - reduction in the scale of the polypoid mass with the help of medications.

People with status asthmaticus should not take acetylsalicylic acid as it always results in shortness of breath.

In those situations where the neoplasm does not allow a person to breathe normally, creating a risk of complications and critical conditions, the surgeon performs an operation on the nose - the removal of polyps, a short-term procedure that requires subsequent compliance with certain hygiene procedures.

How to get rid of polyps in the nose without surgery?

Polyps tend to grow in size. At the 1st stage of the disease, they overlap the upper part of the nasal cavity, and at the third stage, the entire space is already obstructed. Polyps make breathing difficult and disrupt the sense of smell, absorb all infections like sponges.

That is why experts recommend starting treatment as early as possible. Allocate drug, surgical therapy, as well as homeopathy, physiotherapy, breathing exercises. The scheme and method of therapy largely depend on the cause and neglect of the disease.

Conservative treatment

The drug effect is designed to eliminate factors that affect the rate of reproduction of pathogenic cells. It can be a whole range of procedures. Sometimes, in addition to the otolaryngologist, you need to visit an allergist and an immunologist.

These specialists first prescribe samples, after which they prescribe antihistamine tablets and advise avoiding contact with a certain irritant, as well as with infectious and fungal agents.

As a rule, second-generation antigens are used, which do not have a cardiotoxic and sedative effect:

Loratadine Cetirizine Levocetirizine Aerius

If the cause is intolerance to acetylsalicylic acid, products containing salicins are excluded from the diet, it is forbidden to use drugs whose active substance is aspirin.

Use of oral corticosteroids

As unfortunate as it may sound, today hormones remain the drugs of choice. Most often prescribed prednisolone. Its dosage in adults: 30-60 mg for a week, then gradually reduce the number of tablets taken over 21 days until complete failure.

The pediatric dose is calculated individually according to the formula: 1 mg of the drug per kilogram of body weight per day.

The effect of the drug in question is based on a reduction in the rate of cell division. This does not allow the mucosa to grow further, the growth itself collapses over time.

Patients with asthma or rhinitis respond best to such therapy. At the same time, for those patients whose pathology is not associated with an allergic reaction, prednisolone may not help at all.

The method also has significant drawbacks: in order for the tumor to resolve, the patient is prescribed to take large portions of the drug daily for a long time.

This will relieve the disease in question, but it can lead to other problems: obesity, a drop in immunity, an ulcer, and other side effects that GCS has enough.

Therefore, there is another way: injections directly into the outgrowth itself. The choice and dosage of the drug is carried out for each individual person on an individual basis.

The patient is given two injections with an interval of two weeks. Further, the polyp will gradually decrease (dead cells are removed by blowing the nose).

If everything is done correctly, and the drug is chosen correctly, the polyp will completely disappear in 1-2 months. But this does not guarantee that the problem will not return again after a while.

In light of this, it is important to establish the causes of the disease and regularly carry out preventive procedures: gymnastics, washing, diet, etc.

Topical corticosteroids

This group includes hormonal sprays. With their help, you can stop the reproduction of small neoplasms. But they are not as effective for massive growths. The most popular drugs in this group are:

Nazarel and Flixonase, Fluticasone, Avamys and others with the active ingredient Fluticasone. Nasonex (Mometasone). It is approved for use in children over the age of 2 years and has a high anti-inflammatory activity. Budesonide, as well as Aldecin, Baconase and Nasobek.

Decongestants may be prescribed to reduce swelling and ease breathing (no more than a week in a row).

Indications for surgery:

Great difficulty in nasal breathing. The presence of local pustules and inflammation.

Contraindications:

Exacerbation of asthma or obstructive bronchitis. Flowering period of allergenic plants. Folk remedies for the treatment of nasal polyps Folk remedies are good to treat small formations in the nose, or use them to prevent relapse. If the growth is large, it is recommended to add medicines to such procedures.

Amazing results as a non-pharmacological treatment for polyposis shows celandine. Here are some good recipes.

Juice

Celandine flowers are twisted in a meat grinder. Squeeze the juice and pour it into a glass jar, cork and put in a dark place for 6-8 days. Every day you need to open the lid in order to release air. The resulting liquid is diluted in equal proportions with chilled boiled water. She needs to bury her nose daily in the morning, 2 drops.

The frequency of procedures - 7 days, then a break for 10 days, and so repeat 4 times. Then pause for a month and repeat the course.

Tincture

A teaspoon of the dried crushed plant is poured into 300 ml of boiling water, wrapped, allowed to infuse for 20 minutes and filtered. After the tincture has cooled, soak cotton swabs with it. Insert a swab into one nasal passage for 10 minutes, then into the other. Frequency - once a day.

The treatment regimen is as follows: 7 days healing, the same interval - and so on for 60 days. After that, they take a break for a month and repeat all over again.

Daily nasal rinsing is effective if breathing is very difficult. Here you should act carefully, remove the formed crusts and mucus. Sometimes a doctor does this, but it is allowed to perform these manipulations at home with the help of a rubber bulb.

Recipe #1

2 tsp sea ​​salt A glass of warm water.

Recipe #2

1 tsp salt is diluted in 1 tbsp. water, having a temperature of 36-40 ° C, and 3 drops of iodine. Make cotton turundas, and, after soaking them in iodine, treat the polyps

You can also use ready-made solutions: Otrivin-Sea, Dolphin, Aqua-Maris, Marimer.

It is worth noting

In some cases, homeopathy gives excellent results. However, it will not be superfluous, especially if polyps are in children, to arm yourself with the opinion of specialists.

After all, if we are talking about growths that have arisen as a result of the influence of an irritant, the situation can be aggravated with the wrong choice of medication. Most often, Tuya 200 or propolis is prescribed from this series.

Minor growths can be treated with hydrogen peroxide. Processing is carried out 1-2 times a day, no longer than 7 days in a row.

Moisten two cotton swabs with peroxide. Insert into nostrils for 3-4 minutes.

Special gymnastics restores the ability to breathe through the nose. The methods of Buteyko or Strelnikova helped a lot of people. It will also be useful to do self-massage of the trigeminal nerve.

So, let's answer the question of interest to many: is treatment effective without surgery?

It is important to understand that the above methods are fruitful in terms of prevention, aimed at preventing a recurrence. They allow you to slow down growth and make breathing easier. But if the polyp is already in the nasal cavity, it may not disappear by itself.

Removal of polyps in the nose. Operation types

When polyps interfere with normal breathing and do not respond even to prolonged drug treatment, surgical intervention is required.

Since this is an outpatient procedure, the patient returns home within a day. Full recovery occurs in about two to three weeks. People with a bleeding disorder, coronary artery disease, or asthma removal of polyps in the nose is prohibited.

How polyps in the nose are removed depends on the number, size and location of the pathological growth. The doctor will choose the most optimal method from among the existing ones.

Polypotomy. The most reliable and proven operation to remove polyps. It is performed in the case when there is a single pathological growth, if the elements are multiple, their endoscopic elimination is proposed.

It's important to know

Before the procedure, mucus is removed from the cavity and local anesthetics are injected. Given the fact that the forthcoming actions are painful, the patient is given general anesthesia.

A dilator is inserted into the nasal cavity - this allows the surgeon to get a clear picture of the clinical picture.

The intervention consists in using a wire loop: the doctor circles it around the outgrowth, tearing it off the surface of the mucous membrane with a sharp movement. This removal option is very traumatic, since a certain area of ​​\u200b\u200bhealthy tissue is damaged: it is simply impossible for a doctor to predict the situation and guarantee the absence of bleeding.

Sometimes, if the nasal passage is very narrow, the surgeon may place plastic splints to prevent adhesions to the lining as it heals.

In some cases, surgery in the nose is performed with a shaver - a special cutting device with which the surgeon excises the neoplasm, clearing the inside of the nose from its remnants with tweezers. Then, in order to avoid bleeding, tamponade is performed with the possible application of an aseptic dressing.

Functional endoscopic surgery of the paranasal sinuses. It has proven to be a minimally invasive technique, where the exact elimination of the polyposis phenomenon can be carried out along with the cleaning of the sinuses, thus restoring air access and functional capacity.

This procedure can be performed under local or general anesthesia. The surgeon inserts an endoscope, a small tube with magnifying optics or a microscopic camera, into the airway. Then, using tools, the doctor removes growths that interfere with the outflow of mucous secretions from the nasal canals.

It should be emphasized that the surgical operation to remove the nasal polyp, performed by an experienced otolaryngologist, is a safe manipulation, in most cases without complications.

Laser coagulation. This is the principle of eliminating polyposis - the key to solving the problem of shortness of breath caused by blockage of the nasal passage by abnormal mucous formation.

The technique is based on the use of carbon dioxide, the beam of which is focused on the structure of the polyp for 5-7 seconds, reducing the size of the mucous neoplasm and subsequently completely eliminating it.

A laser pulse is delivered from a special probe with a thin diameter, which allows the doctor to control the course of coagulation, saving healthy tissues from damage.


Along with dosed laser energy, warm water is used: during the manipulation, the surgeon flushes the sinuses, which gives a better visualization of their structure, which prevents the recurrence of this problem.

It is worth noting

Comparing this method with a surgical or endoscopic analogue, a number of advantages can be distinguished: it is performed on an outpatient basis and is characterized by excision of only the affected areas of the membrane.

The intervention begins after preliminary local anesthesia and lasts no more than 50 minutes. Thanks to high concentration laser energy is applied, there are fewer violations of the integrity of the cover of healthy tissue, there is no postoperative redness, swelling, pain and other secondary complications, and the recovery itself occurs much faster.


Such an operation is considered quite flexible, therefore laser nose treatment is recommended in cases where the neoplasm is localized in the region of the olfactory fissure, middle turbinate, and posterior septum.

Traditional sinus surgery. It is a treatment option mainly for severe infections. Skin incisions are made for direct access to the inside of the nose. The method is carried out infrequently, since it has a long rehabilitation period and a wide range of possible complications.

To avoid false expectations, a patient scheduled for polyp surgery is informed that their sense of smell will not be restored immediately after the procedure.

After surgery: possible complications

There is a small risk of infection at the incision site. If there is increasing pain in the cheekbones, headache or fever, this means that an inflammatory process is developing, and you need to seek medical help. Taking a course of antibiotic therapy usually solves the problem.

Bleeding or profuse purulent discharge from the surgical wound. If there is damage to the nasal septum, there is a possibility of developing nosebleeds or a hematoma under the eye.

The fact of massive blood loss during the operation requires the surgeon to immediate termination. Rarely, severe or persistent postoperative epistaxis is noted, suggesting an examination of the wound.

During surgery, the surgeon may inadvertently damage the bone that provides the barrier between the nose and the brain. This leads to leakage of CSF (cerebrospinal fluid), which increases the risk of postoperative meningitis, a severe infection of the brain and spinal cord.

Meningitis can be life-threatening and present with severe headache, fever, or stiff neck. As a rule, the phenomenon is determined and eliminated during the operation, without causing additional difficulties.

In some cases, affected patients may require additional surgery to repair tissue from the damaged bone.

Postoperative wound care includes the following:

avoid blowing your nose for the first 3 days after the procedure; daily spray in the nasal cavity saline; apply a warm compress several times a day - this will help relieve mild discomfort; take the full course of the prescribed medication; do not stay in places of high dustiness.

Surgery is not the ultimate solution to the problem of nasal polyps. Unfortunately, there is no guarantee that growths and adhesions in the nose after surgery will not reappear after their surgical removal.

Some people are susceptible to this condition, and the fundamental factors that predispose to their occurrence have not been reliably established.

Nasal polyps symptoms and treatment: video

Good evening! Throughout the pregnancy, starting from the 10th week, I am worried about constant bleeding from the nose when blowing my nose and touching, crusts in my nose. The gynecologist did not attach any importance to the complaints, saying that this is normal for pregnant women, since the amount of blood increases, that everything will pass. At 33 weeks, the ENT during examination discovered a bleeding polyp in my left nostril. He sent me to the day hospital for removal. But on the same day I was sent to the hospital with the threat of premature birth. Now I’m 37-38 weeks old, I bleed daily when blowing my nose and I can’t breathe normally and I see this growth in the mirror already in the nostril, it has grown in just a couple of weeks. I can't sleep at night because I can't breathe. I want to pick up the crusts that grow on it all the time, because I can’t breathe and, as a result, blood flows in a stream again and again, sometimes very plentiful. Tell me, can I remove this polyp at this stage of pregnancy? My tests are normal, but the last time hemoglobin was 107. Thank you!

Yilmaz Olga, Russia, Moscow

ANSWERED: 09/07/2014

Good afternoon Olga! There is no point in removing a polyp at 38 weeks after you have gone through the entire pregnancy with it. Give birth calmly and then calmly remove the polyp, especially since the birth will occur within 2 weeks on average, and maybe a little earlier, since the gestation period is + / - a couple of weeks

ANSWERED: 09/12/2014

If there is a polyp in the nose, there will definitely be sinusitis, since the polyp closes the hole that communicates the sinus with the nasal cavity, especially if the polyp is approximately medium in size. You also need to take into account that the presence of a polyp is a sign of allergization of the body, and if there is an allergy, discharge from the nose can be of a different consistency. I would recommend that you go through several procedures for washing the nasal cavity and sinuses using the "cuckoo" method with an antibiotic (I usually use a solution of Dioxidine) and a solution of diphenhydramine, take lorotadine for 10 days inside, inject bioporox into the nasal cavity according to the instructions, after which a very good drug avamys 14 days 2-3 injections. In the absence of a result and a large size of the polyp, its removal.

Similar questions:

There is no specific information about the etiology of this disease. Since this disease occurs more often in women, its endocrine nature is suggested. There are other "theories", such as traumatic, inflammatory, oncological, but there is no reason to consider one of them more real than the others.

pathological anatomy

Macroscopically, a bleeding nasal septal polyp is a round tumor ranging in size from a small pea to a large cherry, dark red or bluish in color, papillary or mushroom-shaped, on a stalk, bleeding easily when touched, often bleeding spontaneously, especially when sneezing or blowing your nose. The density of the tumor is determined by the ratio of vascular and fibrous tissue.

The microscopic structure of a bleeding polyp of the nasal septum is diverse and is determined by the composition of the vascular and connective tissues, often the tumor also contains inflammatory elements such as granulation tissue. In foreign literature, due to the diversity of the histological structure of the bleeding polyp of the nasal septum, this tumor has received many names: inflammatory granuloma, angiofibroma, pure angioma, cavernous angioma, telangiectatic fibroma, papillomatous fibroma, etc.

A nasal polyp is an overgrowth of the mucous membrane protruding into the cavity or sinus of the nose. They arise as a result of benign changes in the mucosa. The curvature of the nasal septum, changes in the endocrine, immune, and nervous systems predispose to polypogenesis.

Causes of formation and symptoms of polyps

Mucous growths in the nose occur with polypous allergic rhinitis (runny nose) or rhinosinusitis. When the process spreads to all sinuses, the phenomenon of polyposis pansinusitis is simultaneously observed.

Types of polyposis

Allocate polyposis:

multiple; unit; deforming.

The causes of polyposis are considered allergens that enter the body from the outside, and auto-allergens produced by the body itself in response to infection. Autoallergens are formed in response to a malfunction of the immune system, which begins to perceive the nasal mucosa as a foreign tissue.

Mucosal changes

With frequent inflammations, traumatic irritations, the mucous layer changes its structure, the connective cells of the submucosal layer grow, fibrous degeneration of the polyp begins. The resulting polyp may resemble papilloma, adenoma, fibroma in appearance.

A polyp is a benign non-tumor formation that is not life threatening. Polyps never degenerate into malignant tumors.

Polyps are more common in adults. In children, this phenomenon is rarely observed. Symptoms of polyps include snoring during sleep, difficulty breathing through the nose, and frequent colds. The patient may suffer from frequent headaches, discharge from the nose.

With large growths that impede breathing, symptoms of oxygen starvation may be observed. The patient's health worsens, irritability appears, sleep is disturbed.

Formations can reach the size of a chicken egg, but more often they are small in size. They differ in growth rate, localization. Large polyps can be injured and bleed, and with a sneeze or blowing their nose, they come off and are removed.

Polyposis can be observed on one side of the face, mainly with the formation of polyps in the maxillary cavity or cells of the ethmoid bone. Bilateral polyposis occurs as a secondary disease of the atopic allergic process.

single polyp

A single (solitary) polyp always occurs only in adults. The place of its formation, as a rule, becomes the maxillary cavity, sometimes the ethmoid labyrinth or the sinus of the sphenoid bone.

Around the polyp formed in the maxillary nasal cavity, polyposis growths are noted, in the photo you can see the altered mucous tissue.

The growth of a solitary polyp can occur towards the nasal cavity or towards the nasopharynx.

With a large size, the polyp prevents free nasal breathing. Large growths cause a violation of the voice, lead to the appearance of a closed nasal.

With especially large polyps in the nose, irritation of the posterior wall of the nasopharynx is observed, which causes a gag reflex. Changes also apply to the auditory tube, its ventilation function is disturbed. As a result, there is stuffiness of the ear from the side of the polyp, hearing loss.

Multiple polyposis

The process of polyp formation can go on for a long time and lead to their multiple growth in the sinuses. Formations can spread to all sinuses of the nose, penetrate into the middle ear, auditory tube.

Deforming polyposis

It occurs in young people, has an infectious-allergic nature, there is a hereditary predisposition to the disease. Deformation of the nasal septum is observed in cases of insufficient treatment with the appearance of polyps in the nose up to 20 years.

The deformation of the nasal septum is caused by the pressure of growing polyps in children; in the photo of patients who have not received treatment, there is asymmetry of the nose and a change in its shape.

Symptoms of the formation of polyps in the nose are manifested in children by the inability to breathe through the nose, such a child is constantly with his mouth ajar. In childhood, this leads to such an unpleasant consequence as malocclusion.

The tissues of the bones of the skull, which have not been formed yet due to childhood, are deformed under the pressure of growing polyps, which causes a distortion of the outlines of the face, a visible violation of proportions.

The pressure of polyps in the nose and paranasal sinuses causes a violation of blood and lymph circulation, leads to venous stasis, which is accompanied by symptoms of hydrocephalus, dropsy of the brain. A sign of a polyp in the nose can be a complete lack of smell.

Loss of smell in deforming polyposis is irreversible.

Localization of nasal polyps

The appearance of polyps is caused by an increase in the general allergic sensitivity of the body, and their formation in the nose is caused by a weakening of the immunity of this particular organ. The approach to treatment depends on the nature of the process, there are:

Polyps in the nasal cavity, ethmoid labyrinth. The process is usually two-way. The nasal cavity, all the sinuses are filled with polyps, the septum is deformed, the nose as a whole looks asymmetrical. Polyposis is observed on both sides. A single polyp comes from the maxillary cavity, clogs the nasal cavity, disrupting nasal breathing. Marked on one side.

Polyposis is usually bilateral, excluding single formations. Unilateral growths in the sinuses of the nose can be symptoms of papilloma, cancer.

Diagnostics

Polyposis is diagnosed using histological examination and computed tomography. In order to properly prescribe treatment, the polyp is differentiated from other formations in the nose: myxomas, pedunculated adenomas, tumors.

Patients are tested for allergies and x-rays to detect growths in the paranasal sinuses.

Treatment

The treatment of polyposis is complex, it consists of treatment with antiallergic drugs and surgery. Therapeutic measures are based on the results of the examination of an allergist, a pulmonologist. Before the operation, a three-day course of prednisolone is prescribed.

Nasal polyp removal surgery

With a limited distribution of polyps in the nose and cells of the ethmoid bone, the operation is done with a polyp loop, microdebrider, Braxley forceps.

Removal of a polyp loop

The operation is performed under local anesthesia with lidocaine. The loop is introduced into the nasal passage, put on the body of the formation, gradually shifting to the leg. Then tighten the loop and cut off.

Removal with braxley forceps

Anesthetize locally with lidocaine. Under visual control, special Baxley forceps capture the polyp, trying to immediately capture its base, then remove it.

Removal with a microdebrider

Anesthesia is performed with lidocaine. The polyp is cut off with a microdebrider (shaver) - a tool equipped with a sharp blade that cuts the growth to the very base, and then sucks it up. When removed in this way, bleeding is possible, which is stopped by the introduction of a tampon or turunda.

Removal of multiple nasal polyps

With polypous pansinusitis, when all paranasal sinuses are filled with polyps, removal is done under general anesthesia. Before the operation, a computed tomography is required to determine the nature of the polyposis.

Polyposis is often observed with deformity of the nasal septum. In these cases, intervention begins with septoplasty - surgery to correct the shape of the nasal septum.

Then the cells of the ethmoid bone are cleared of polyps, penetrate into the posterior cells, and pass to the sinus of the sphenoid bone. Using a scalpel, the wall of the sphenoid sinus is perforated, expanded with forceps and penetrated into the cavity of the sphenoid bone.

Then, the growths of the mucous membrane are removed from the cells of the ethmoid labyrinth and the frontal sinuses are examined. The operation is completed by removing polyps from the maxillary sinus, removing them with Baxley forceps from the surgical wound. Having finished the operation on one side, perform the same actions on the other.

Endoscopic polypotomy

The method of endoscopic surgery can remove single polyps growing from the maxillary cavity, blocking the nasal passage, interfering with breathing.

The operation manages to completely restore breathing through the nose, but the cause that caused the disease is not eliminated in this way. After the operation, it is necessary to undergo antiallergic treatment, to establish the cause of polyposis.

The operation is performed under general anesthesia using an endoscope and a microdebrider. First, it is possible to eliminate the part that goes into the nasal cavity. Then the paranasal cavity from which the polyp grows is determined, and its remaining part is removed.

Usually it is necessary to remove the residue that fills the entire cavity from the maxillary sinus.

The operation for the removal of nasal polyps is a planned one. The patient is prepared in advance, treated, so there are practically no complications.

Removal of polyps with a laser

Removal of polyps in the nose with a laser is an endoscopic operation, performed under visual control. Refers to gentle methods. The procedure for removing a single polyp does not take more than 20 minutes, it is performed under local anesthesia.

The method of removing polyps in the nose with a laser is suitable for both single growths and extensive ones, the price of the operation depends on the degree of polyposis. Removal of a single polyp in the nose will cost about $300, laser treatment for severe disease is somewhat more expensive.

The operation is sterile, is not accompanied by bleeding, and is characterized by the absence of postoperative complications.

Endoscopic laser removal of nasal polyps is performed under visual control. The laser cuts tissues, through the incision the formations are evaporated with a beam, and the overgrown tissue is destroyed. After the operation, the patient is prescribed treatment with drugs, vitamins, inhalations.

Polyps may reappear after removal. To prevent relapse, the patient must undergo a diagnostic examination and follow the doctor's instructions. Flixonase spray is considered the best remedy for relapses.

The remedy for polyps should not be used as drops, in the form of a spray, the dosage in the nose is more accurately observed, the drug enters the mucous membrane in the form of tiny drops. A good effect on polyposis is provided by sprays aldetsin, avamys, nasobek, beclomethasone, beconase, benorin, rhinoclenil, nazarel.

You can use drugs under the supervision of a doctor, the funds help after surgery to remove growths. You should not try to use them instead of surgery, this may worsen the condition.

Treatment of nasal polyps without surgery

Often, after the removal of mucous formations by surgery, they reappear. This is explained by the fact that the operation does not eliminate the very cause that caused the appearance of the polyp.

Non-surgical methods of treating polyposis include procedures for washing the paranasal sinuses, saline inhalations, the action of ozone, a laser.

Physiotherapeutic methods for the treatment of nasal polyps allow you to do without surgery by improving blood and lymph circulation in the tissues, improving the condition of the mucosa.

Treatment with folk remedies

Giving preference to folk remedies for the treatment of nasal polyps, it should be borne in mind that the causes of mucosal growth are impaired immunity, allergies to various substances. Many medicinal plants in folk recipes can cause allergies and worsen the patient's condition.

When choosing a method for treating polyps in the nose with folk remedies, you need to focus not only on the reviews of other people, but also on the data of your own examination for allergens. You can start self-treatment of nasal polyps at home only after determining the examination by an allergist and identifying allergens that can cause a reaction.

It is useful to eat 2 handfuls of viburnum per day for a month. From this disease, they drink beet juice, settled for 3 hours in the refrigerator, carrots, with the addition of garlic onions. It is useful to do nasal lavage with saline, sea water. Oil of sea buckthorn, thuja, rosemary, St. John's wort is instilled into the nose with polyps.

Complications

The presence of polyps in the nasal cavity and paranasal sinuses cause complications in the respiratory system, causing bronchial diseases, provoking attacks of bronchial asthma. Polyps contribute to changes in the digestive system, causing bloating, aerophagia - swallowing air, followed by belching.

Among the complications of deforming polyposis, catarrhal, purulent otitis media, asthmatic bronchitis, cholecystitis, colitis, and pancreatitis are also noted.

Prevention

Prevention of the appearance of polyps consists in anti-allergic treatment aimed at reducing the body's sensitivity to allergens. Prevention includes treatment of sinusitis, ethmoiditis, timely elimination of foci of infection.

The patient should undergo a scheduled examination by an otolaryngologist several times a year and take supportive treatment.

Forecast

Prognosis is good with appropriate treatment

For various reasons, benign formations sometimes appear on the mucous membrane of the nasopharynx or on the inner surface of the paranasal sinuses - polyps in the nose. They do not hurt, but only cause discomfort. Mature polyps are round in shape, are single or may appear in groups. For adults, this disease is not uncommon and often resembles asthma or allergies. Untimely treatment of these non-painful tumors leads to rather negative consequences.

At-risk groups

Nasal polyps are an inflammation of unknown origin, because science still does not know why they appear in the nasal cavity. The statistics show that:

Nasal polyposis in women is twice as common as in men. After the age of 20, the risk of polyps increases. Polyps are most susceptible to people from the age group after 40 years. A child with cystic fibrosis is more likely to have such problems.

Stages of development and types

Nasal polyps, given their size and the changes they provoke, are divided into three stages:

I. First. Polyps appear, filling only a small part of the nasal space and without causing unnecessary discomfort. II. Second. Tumors increase rapidly, grow, cover a significant part of the nasal cavity, making it difficult for a person to breathe. III. Third. The formations completely block the respiratory passage, and the person breathes poorly through the nose, the sense of smell disappears. As a result, organs and cells receive less oxygen, because its intake through the mouth is not enough.

Based on the place of origin, polyposis can be:

Ethmoid, developing from the ethmoid mucosa. It affects both sides of the nasal septum on the ethmoid tissue, mainly in adults. Anthrochoanal, arising from the maxillary sinuses. More common in childhood and is located on one side.

Very often there is a choanal polyp growing from the maxillary "pockets", as well as anthrochoanal. The choanal type develops from a retention cyst.

Causes and conditions for the appearance

Frequent colds are one of the causes of polyps.

The reasons that create fertile ground for the occurrence of polyps, scientists call:

hereditary predisposition; regular colds and infectious diseases with a runny nose (for example, vasomotor rhinosinusitis); pathological immune reactions; a polyp of the nasal septum occurs with a strong curvature of the nose, so a person breathes poorly; inflammatory processes in the paranasal sinuses, chronic sinusitis, frontal sinusitis; allergic rhinitis due to for inhalation of dust, pollen, animal hair and others.

Possible risk factors

Doctors have indicated which diseases can be accompanied by polyposis and vice versa. Here is their list:

Bronchial asthma - causes inflammation of the airways and their narrowing. Allergic rhinitis and fungal sinusitis. Cystic fibrosis. Alcohol intolerance. Genetic disorders - muscovidosis. Chronic sinusitis in combination with rhinitis (sometimes vasomotor) and rhinosinusitis. in the nose. Churg-Strauss syndrome.

What to do if a person finds a familiar disease in this list? Contact a specialist immediately.

Pathogenesis

Early inspection is the best prevention.

When an infectious disease affects the nasal cavity, microorganisms begin to actively multiply on it. As a result, the first layer of cells detaches, signs such as itching, congestion, a change in the timbre of the voice appear, and mucus flows out. All this is treated in 10 days. Some people themselves refuse treatment, dooming themselves to chronic processes of the nasal membrane. The mucous membrane loses its strength, and in an attempt to fulfill its purpose fully, it begins to spread and thicken. At one point, the overgrown connective tissue penetrates into the space of the nose and a condition begins in which they say that a polyp has come out, which is the result of various infections of different parts of the nose and is a translucent, non-malignant formation that grows on the lattice tissue, in the sinuses, their clinic and localization is varied.

The process of polyp formation is not fully disclosed, but most doctors agree that polyposis is both the root cause of the inflammatory process and its result.

Psychosomatics

This is a peculiar approach to health problems, which is based on the doctrine of the unity of the psychological and bodily state. Based on its principles, the nose is a source of information, and if its ability to breathe is gone, then the information stops coming. Congestion shows a person's desire to hide something, to run away from problems and resentment. This is a lack of confidence in oneself, one's strengths, which means that the desire to achieve something has disappeared.

Polyps are symptoms of hidden vulnerability, a feeling of hostility from others, resentment at reproaches, a desire to understand why it is so difficult to be useful. Psychosomatics claims that if a polyp has become inflamed, it means that a person wants to hide his disappointment so as not to “drop” his face in society.

Symptoms

Symptoms of polyposis in an adult are:

For a long time, a person has difficulty breathing due to a stuffy nose, which is caused by blocking the passage for air. The sense of smell was lost when the receptors blocked by the cyst failed. Runny nose. Snoring. Severe headache, the clinic of which may be different. sneezing due to irritation from a cyst of cilia in the nose. Changes in voice, nasality.

In children, the symptoms are similar, but with some additions:

snoring; loss of smell; hoarseness; purulent, bloody discharge (from a bleeding polyp); headache as a result of impaired blood circulation; stuffy nose and rhinitis (including vasomotor); shortness of breath; poor appetite; intestinal disorders.

True signs of the fact that the baby has polyposis is a constantly open mouth, the lower jaw sags, the nasolabial folds are smoothed out, the outlines of the face and the dentoalveolar system change. In the worst case, they subsequently manifest themselves in the incorrect formation of the chest bone. In infants, sleep and sucking disorders can be traced, they weaken and lose weight, becoming vulnerable to infection of the lungs and bronchi. And such consequences are life-threatening.

During pregnancy, mothers themselves can determine whether they have a bleeding polyp or a cyst without visible manifestations. The symptoms are identical to the previous categories, but itching around the eyes and tearfulness may be added, the frontal bones hurt due to increased pressure, the mother looks unhealthy, and the pronunciation of speech worsens.

Possible predictions

Complications of an advanced state of polyposis are quite dangerous:

If the cystic outgrowth reaches medium parameters, it can provoke sinusitis, vasomotor rhinitis. If the polyp has grown even more, then the entire respiratory system may be complicated. The advanced stage clinic entails sleep apnea (stopping breathing during sleep, at first it is accompanied by snoring). It is possible to block the paranasal and maxillary "pockets". Due to the fact that a person begins to inhale cold air through the mouth, exacerbation of bronchitis and pneumonia is noted. As a result of impaired blood circulation in the tissues of the nose, tonsils and adenoids become inflamed. Sometimes inflamed adenoids are excised, their washing and medicinal effects rarely reduce adenoids. During pregnancy, untimely treatment of polyps leads to partial or complete loss of hearing, speech, and loss of the ability to recognize smells and tastes is possible. And mother's diseases (bronchitis, vasomotor rhinosinusitis, inflamed adenoids) negatively affect the baby inside her.

Diagnostics

To find out if a person has polyps in the nose, you need to contact the ENT doctors, who themselves will interview the patient and examine the nasopharynx using an endoscope and a rhinoscope. With a cyst that is located near the nostrils, it is easier, because it is easy to detect visually. If the polyp has grown in the depth of the nasal passage, additional methods of differential diagnosis will be required. List of necessary auxiliary examinations:

computer and magnetic resonance imaging of the paranasal sinuses, which will help to find out the dimensions of the polyps, their location; x-ray, which allows you to examine the area of ​​​​the lesion; you need to do allergic tests that show a reaction to medications by introducing allergens into the forearm and obtaining results of the presence or absence of allergies; histology methods suggest a biopsy to see what the cyst looks like and whether it is malignant; a blood test; a test for cystic fibrosis, indicating a hereditary predisposition to form a neoplasm, sometimes referred to as a cyst.

Such a differential diagnosis (histology) excludes other possible inflammatory processes and structural abnormalities (malignant and benign). During pregnancy, CT and MRI are rarely used, doctors often prescribe an x-ray, which has less effect on its course. In childhood, X-rays are also prescribed first of all.

Methods of treatment

To answer the question of how to treat nasal polyps, you need to determine the causes of the disease that triggered their appearance, and at what stage they were detected. There are several ways to cure a person from polyposis:

Conservative treatment

Conservative treatment with quartz fiber.

The main directions of conservative treatment:

Elimination of such factors: exclude contact with allergens (their main types are pollen, dust, drugs, chemicals); agents of fungal and infectious origin that are not excreted in the urine; stop taking anti-inflammatory nonsteroidal drugs, some of them remain in the body, and the other is excreted in the urine ; refuse products with natural salicylates, harmful additives and chemical dyes. Rinsing with sea salt solutions to rinse the nasal cavity, respiratory passages and mucus congestion in the sinuses well. Application of the Buteyko method, in which a person breathes according to special patterns, Strelnikova's gymnastics, technician self-massage. Homeopathic therapy. Drug treatment, the scheme of which includes one or more drugs: antihistamines; corcosteroids; decongestants; cromoglycates; antibiotics. Antibiotics help to remove the manifestations of infectious processes. Immunotherapy, which is based on the restoration of the immune system, immunocorrective drugs are used. Herbal medicine, if there is no allergy. A conservative method using quartz fiber. A quartz fiber is placed in the nasal cavity, which should warm the tissue and help the cyst move away from the nasal membrane, and the doctor removes the formation, relieving the patient of the disease.

Now almost any clinic offers a wide range of ways to cure polyps, people themselves choose from the list offered to them.

Surgery

Removal of polyps with a loop.

When contacting a doctor at a late stage or when medications do not bring the desired results, an operation is prescribed during which the polyps are removed. The indications for surgery are:

frequent asthma attacks snoring impaired sense of smell deviated nasal bridge increased nasal congestion bleeding discharge with an unpleasant odor that exudes a bleeding growth.

Nasal polyps are removed in several ways:

Polypotomy. Allows you to remove polyps with a cutting loop, and several cysts can disappear at once. It is carried out strictly in a hospital, has a significant flaw - the reappearance of growths is possible. There are contraindications: heart disease; poor blood clotting; acute cold. Endoscopy. An endoscope with a miniature camera is inserted into the opening of the nose, the picture from which is displayed on a large screen, which helps to find out the size and number of polyps (even bleeding ones), and then remove them without affecting the bones in the nasal cavity. No scars or visible damage. This method is not recommended for people who have an exacerbation of chronic bronchitis and asthma, women with menstruation. Removal with a microdebrider. This is a subspecies of the previous method, the difference of which is in the tool, in this case it is a microdebrider (shaver). It allows the maximum number of polyps to disappear down to the healthy layer of the nasal mucosa, crushing the choanal polyp and others in the sinus and sucking them up. These types of interventions exclude relapses. Unfavorable conditions for carrying out - acute inflammation, colds, possible allergic reactions. With the help of a laser. Allows you to get rid of polyposis on an outpatient basis. The procedure is safe at any age and its essence is as follows: an anesthetic medicine is injected into the nasal cavity: then an endoscope with a laser, with which the doctor can heat the cells that make up the polyps, as a result, the latter evaporate; all vessels are sealed with a laser beam, which will help reduce the likelihood of bleeding. People who have nasal polyps removed in this way may not have to worry about getting an infection. After that, you should visit a doctor for a couple of days to monitor the condition of the mucosa. You can not do the procedure for women during pregnancy, people with obstructive bronchitis, multiple polyposis. Disadvantage: there is no opening of the sinuses, the polyposis tissue is not completely removed.

Treatment with natural remedies

They eliminate the causes that caused the disease. Herbal preparations restore the full functioning of the nasal mucosa and can reduce the size of polypous cysts. When polyposis tissue grows too profusely and forms large polyps in the nose, natural decoctions are ineffective. Polyposis is treated:

Drops that need to be dripped directly into the nose from such components as celandine, anise, St. John's wort, succession, horsetail. But you need to drip strictly as prescribed by the doctor. Ointments, which include propolis, honey, a mix of oils (sea buckthorn, ledum, St. John's wort, propolis). Inhalations with propolis, celandine, and pharmacy chamomile help well. Inhalations will have a beneficial effect on related problems.

Science does not stand still, so there is no need to be afraid of the diagnosis of nasal polyposis, its treatment and responsible attitude to well-being will help get rid of this disease for a long time. Among the non-traditional means of getting rid of polyps is an antiseptic - Dorogov's stimulator (ASD). Created from the tissues of frogs by high-temperature distillation, ASD has shown incredible positive results in practice. It turned out that asd helps to cope with problems such as tuberculosis, cardiovascular ailments, skin sores and, of course, polyps. In fact, asd is a biogenic stimulant with antimicrobial action.

Prevention

To reduce the likelihood of relapse, you must:

Monitor the state of existing allergies and asthmatic manifestations, follow the doctor's recommendations and, in the absence of visible positive changes, change the course of treatment. Eliminate sinus irritants, that is, minimize the inhalation of tobacco smoke, dust, chemical fumes, which provoke inflammation or irritation in the sinuses. Prevention is impossible without humidifying the air in the house, because dry air worsens the general condition of the nasopharynx. Follow the rules of personal hygiene by thoroughly washing your hands to prevent infection with viruses. You need to rinse your nose with saline, which improves the outflow of mucus to remove harmful microorganisms and prevents the development of sinusitis, vasomotor rhinitis. ensure the proper functioning of the digestive system, periodic cleaning of the intestines and liver. Therefore, doctors advise patients to switch to a separate diet, exclude spicy foods and tonic drinks from the diet.

These rules apply to everyone, and especially for a woman during pregnancy, because she is responsible for two. The younger generation, which has a stronger immune system, needs to get into the habit of hardening, washing, taking vitamins, eating a balanced diet, and undergoing periodic medical examinations. The best prevention is a timely visit to the doctor, and after treatment, these visits should take place several times a year in order not to miss the recurrence of polyps (choanal and others). Prevention is the best way to stay healthy!