Nasal polyps can be one of the more difficult problems faced by an otolaryngologist. It isn’t that they are difficult to remove, but that they can often reappear. Our surgery is much more complete and even if there is some recurrence it will rarely be a noticeable problem for the patient. Although the etiology remains a mystery, it is clearly an immunologic phenomenon. Careful evaluation of all subtle allergies and even occult fungal infections must be considered. Much new information is on the horizon and we will certainly stay current to best serve our patients.
Polyps can be treated pharmacologically with systemic (Prednisone) steroids. These work to shrink the polyps, but the effects are very temporary and you cannot continue on them indefinitely. Many patients will see benefits from directed immunotherapy, so we do consider this before performing surgery. New evidence that the newer leukotriene inhibitors (Singulair) may be of benefit to some select patients. New theories are emerging with regard to a fungal etiology of chronic rhinosinusitis.