Inflammation is likely cause of many nasal polyps

Q: I think I have a nasal polyp. Will I need to have surgery to remove it?

A: A nasal polyp is a noncancerous tumor that grows from the lining of your nose or sinuses, usually in the nasal passages. Nasal polyps often grow in clusters and obstruct airflow in and out of the nose. (I've put an illustration of nasal polyps on my website, AskDoctorK.com.)

Nasal polyps can make it difficult to breathe through your nose. They can make your nose feel stuffy, decrease your sense of smell and cause postnasal drip. Though nasal polyps themselves are painless, they can make your face feel uncomfortable. People with nasal polyps have frequent sinus infections.

Nasal polyps often result from long-lasting inflammation that may be caused by chronic hay fever or asthma. But in other cases, polyps occur for no apparent reason.

An ear, nose and throat specialist can usually detect polyps by examining nasal passages with a nasal endoscope. This is a small, flexible tube connected to a light or camera. Nasal polyps appear as translucent, grapelike, yellow or gray masses. Sometimes the doctor will use a computed tomography (CT) scan to determine the location and size of the polyps. CT scanning also will tell if the polyps are coming from the nose or from the sinuses.

Nasal polyps almost always occur on both sides of the nose. If you have a polyp only on one side, you may need to have a CT scan to make sure that the growth is not something more serious.

If your nasal polyps are small, your doctor may prescribe a nasal spray containing corticosteroids, perhaps along with corticosteroid pills. The nasal spray usually is sufficient and has fewer potential side effects than the pills. Corticosteroids will shrink the polyps slowly and prevent them from returning.

If inflammation as a result of hay fever has caused your polyps, your doctor will recommend lifestyle changes to control your allergies. For example, stay inside when pollen counts are high, and keep air conditioners turned on in your house and car during allergy season. If that doesn't work, then anti-inflammatory medications such as steroid nasal sprays or leukotriene inhibitors can help keep allergy-related inflammation under control.

Some polyps are caused by a reaction to taking aspirin or nonsteroidal anti-inflammatory medicines (NSAIDs). Aspirin desensitization treatments by an allergy specialist can be helpful.

If the inflammation that caused the polyps isn't controlled, then the polyps may reoccur. In my experience, the inflammation can be controlled by lifestyle changes and medicines — if a person really makes those changes and takes those medicines faithfully.

Sometimes, however, even if a person has done everything the doctor recommended, the polyps persist and continue to cause bothersome symptoms. In such cases, particularly when the polyps are large, surgery is required. This is an outpatient procedure in which the surgeon uses an endoscope to remove the polyp. It is simple, and recovery usually is rapid.

• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.