Nasal Polyp Removal

About the Procedure

Nasal Polyp Removal (polypectomy) is a procedure to excise polyps from the nasal and sinus cavities. Polyps are painless, soft, smooth overgrowths of the mucous membranes and are usually benign. Symptoms develop as the polyps become large enough to obstruct nasal passages causing problems with breathing, discharge, infection, and/or loss of the sense of smell. The cause of polyp development is unknown, but is usually accompanied by allergy, inflammation, or underlying disease. Because of a high rate of polyp recurrence, physicians recommend treating polyps using both medical and surgical approaches simultaneously.

Two types of surgical polyp removal are available, the choice being determined by the size, and number of polyps and inflammation involved. Polypectomy, used for small or isolated polyps, is performed with a suction device or a microdebrider to cut and remove the tissue. Endoscopic sinus surgery is a more complex procedure in which a surgeon uses an endoscope to guide instruments to excise larger and/or numerous polyps and to correct the sinus conditions which help create them. Both procedures are done on an out-patient basis using either general or local anesthesia and are completed within an hour.

What to Know Before the Procedure

Polyp removal surgery presents rare but potentially severe risks. The nasal and sinus areas are adjacent to the eyes and brain lining. The roots of polyps can be deep and the surgeon must use skilled judgment to avoid injuries such as blindness, permanent double-vision, and leaking of brain fluid which could lead to meningitis. Lesser complications include permanent loss of the sense of smell and scarring inside the nose and/or sinuses which may eventually require surgery.

Surgery is not a permanent solution to nasal polyps; the recurrence rate is very high. New techniques and implements are continually sought to keep the mucous membranes open and scar-free. Medication is used to address the underlying causes of polyps, allergies in particular. A routine schedule of doctor visits beginning four to five days after surgery is required to control the growth of new polyps.

Preparation for this procedure is similar to other operations. A health assessment, blood work, a review of current medications, especially those which prevent blood clotting, and pre-operative instructions on food and water intake will be provided by the doctor. A CT scan is often obtained for prior analysis and for guidance during surgery. Plan in advance for a ride at discharge as post-operative pain medications may cause drowsiness. Assistance for the first day is recommended since pain and tiredness are the chief complaints during recovery.

What to Know After the Procedure

After surgery there will be a blood-tinged nasal discharge lasting a few days and the patient's nose will be swollen for about two to three weeks. Applying ice packs is helpful for both symptoms. Avoid strenuous activity or heavy lifting. Nose blowing puts sudden pressure on the nasal cavity and must be avoided for two weeks. Sneezing is not uncommon due to irritation; opening the mouth during the sneeze will help avert direct pressure to the nose. Once the pain has subsided patients with sedentary jobs may return to work. Those with more strenuous jobs should consult their doctor.

If you Need to Travel Outside of your Local Hospital

Nasal polyp removal is a simple procedure without a long recovery period for most patients. Therefore, short and long-distance travel for this procedure are equally viable. The technical skill of the surgeon should be the primary concern when deciding on where to have this procedure performed, as it helps avoid complications and minimizes risks.