When the nasal passages experience persistent inflammation, their mucous membrane lining becomes increasingly swollen and fluid-filled. These swollen areas gradually stretch and pull away from the nasal wall, forming polyps with narrow stem attachments. The growths contain inflammatory cells and proteins that contribute to their expansion. Polyps commonly form where sinuses connect to the nasal cavity, particularly in the ethmoid sinuses between the eyes, though they can develop anywhere in the nasal passages.
Nasal Polyps Treatment in Singapore
Nasal polyps are soft, painless growths that develop within the lining of nasal passages and sinuses.
These grey or translucent masses can vary in size, from as small as a grape to substantially larger formations. They occur more frequently in adults over 40 and those with respiratory conditions. While they lead to significant discomfort, including persistent nasal blockage and sleep disturbances, early detection and proper medical treatment often lead to successful management.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
How Nasal Polyps Develop
Symptoms of Nasal Polyps
Nasal polyps cause various symptoms that can worsen over time without proper treatment.
- Nasal Obstruction: The most common symptom is difficulty breathing through the nose, particularly when polyps become large enough to block nasal passages.
- Loss of Smell and Taste: Polyps can block the sensory nerves in the nose, leading to reduced or complete loss of smell and affecting taste perception.
- Chronic Sinusitis: Recurring sinus infections may occur as polyps block proper drainage, creating an environment where bacteria can thrive.
- Sleep Disturbance: Blocked nasal passages can cause snoring and sleep apnoea, leading to poor sleep quality and daytime fatigue.
Causes and Risk Factors
Multiple factors contribute to the development of nasal polyps, from inherited traits to environmental influences.
Genetic Predisposition: Specific genetic variations can make some people more susceptible to developing nasal polyps. These genetic factors often influence how the immune system responds to inflammation.
Environmental Triggers: Exposure to airborne irritants, including pollution, dust, and chemical fumes, can trigger inflammation in the nasal passages. Long-term exposure may increase the likelihood of polyp formation.
Medical Conditions: Conditions such as aspirin sensitivity, chronic sinusitis, allergic rhinitis, and cystic fibrosis have a strong correlation with nasal polyp development. Individuals with asthma or allergies show higher incidence rates due to their ongoing inflammatory responses.
Diagnosis of Nasal Polyps
Diagnosing nasal polyps requires several diagnostic methods to confirm their presence and assess their severity. Common methods include:
- Physical Examination: Diagnosis at the clinic begins with a direct examination of the nasal passages using specialised equipment. A nasal speculum and bright light allow examination of the front portion of the nose. Doctors often use a nasal endoscope (a thin, flexible tube with a camera) to examine deeper areas of the nasal cavity and identify polyps hidden from direct view.
- Imaging Studies: CT scans create cross-sectional images of the nasal passages and sinuses, revealing the precise location and extent of polyp growth. These detailed scans show the relationship between polyps and surrounding structures, measuring their size and distribution throughout the nasal cavity and guiding treatment planning.
- Differential Diagnosis: Doctors conduct specific examinations to distinguish nasal polyps from conditions with similar symptoms. This process includes checking for enlarged turbinates, deviated septum, or other structural variations that may cause nasal obstruction. They also assess for signs of tumours, which require different treatment approaches.
- Allergy Testing: Specific tests help identify allergic triggers that may contribute to polyp formation. Blood tests measure levels of antibodies produced in response to specific allergens. Skin prick tests, where small amounts of potential allergens are placed under the skin, reveal immediate allergic reactions.
Treatment Options
Treatment follows a systematic approach, starting with non-invasive treatments before considering surgical options.
Medications
- Oral Corticosteroids: For larger polyps or when nasal sprays prove insufficient, doctors may prescribe short courses of oral steroids. These medications work throughout the body to rapidly reduce inflammation and shrink polyps within days. Due to potential side effects like elevated blood sugar and mood changes, oral steroids require careful monitoring and are typically prescribed for 5 to 10 days.
- Nasal Corticosteroid Sprays: Topical corticosteroids work directly on the nasal lining to reduce inflammation and slow polyp growth. These prescription sprays, when used consistently, can decrease polyp size and prevent regrowth in many patients.
- Antibiotics: Antibiotics are used to treat bacterial sinusitis that occurs with nasal polyps. The type of antibiotic depends on the likely bacteria and local resistance patterns. Treatment typically lasts 10 to 14 days to ensure complete resolution of the infection.
- Antihistamine Treatment: For patients with allergic components, antihistamines help control the underlying allergic response. These medications block histamine release, reducing inflammation that can trigger polyp formation.
Surgical Procedures
- Polypectomy: This minimally invasive procedure removes visible polyps while preserving the surrounding nasal tissue using specialised instruments, using an endoscope for clear visualisation throughout. The procedure addresses only visible polyps and often works in conjunction with other treatments to manage underlying inflammation.
- Functional Endoscopic Sinus Surgery (FESS): For extensive polyp disease, endoscopic surgery provides a comprehensive solution. Using a thin scope with attached surgical tools, ENT surgeons can access deep areas of the sinuses to remove polyps and improve natural drainage pathways. This procedure also allows for correction of other anatomical issues that may contribute to polyp formation.
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Prevention and Management of Nasal Polyps
Prevention and management of nasal polyps require consistent medical follow-up and daily care routines. Regular use of prescribed nasal sprays and proper nasal irrigation helps keep passages clear and reduces inflammation. Follow-up appointments allow for the monitoring of polyp regrowth and adjustment of treatments as needed, while managing underlying conditions such as allergies or asthma helps prevent a recurrence. These preventive measures, combined with maintaining clean living environments, support long-term nasal health.
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Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.
Frequently Asked Questions (FAQ)
How long does it take for nasal polyps to develop?
Nasal polyps typically develop gradually over months or years. The exact timeframe varies among individuals and depends on underlying factors like chronic inflammation or allergies.
Will changing my diet help prevent nasal polyps?
While no specific diet prevents nasal polyps, some people with aspirin sensitivity might benefit from avoiding certain foods. People with confirmed food allergies should avoid their trigger foods, as allergic reactions can increase nasal inflammation.
Can I use over-the-counter medications to treat nasal polyps?
Over-the-counter medications may temporarily relieve symptoms but cannot shrink or remove polyps. These medications include decongestants and antihistamines, which may help with congestion and allergy symptoms.
How can I tell if my breathing problems are from polyps or allergies?
While both conditions can cause nasal congestion, polyps typically cause a progressive loss of smell and persistent stuffiness that does not vary with seasons or exposure to allergens. Allergy symptoms often fluctuate and may include itching and sneezing.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.
Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.
- 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
- 2016 – Best Educator Award (Eastern Health Alliance)
- 2016 – “Wow” Award (Patient Compliment)
- 2014 – Eastern Health Alliance Caring Award – Silver
- 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
- 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
- 2007 – Singhealth Best Doctor Award
Qualifications
- MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
- MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
- MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
- FAMS – Fellow of the Academy of Medicine Singapore
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A Specialist Clinic for Sinus, Snoring & ENT
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Mount Elizabeth Novena Hospital
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