What is the danger of polyps in the nose? Symptoms, treatment and removal
Statistically, nasal polyps are the most common complication of chronic rhinitis. In the world of them, according to various estimates, suffer from 1 to 4% of people, the majority of carriers are male. They growths are formed in 4 times more often than women. If we turn to the structure of the appendages, the children prevail antrochoanal polyps (are formed from the mucous membrane lining the maxillary sinus), and adult population – ethmoidalis (formed from the mucosa lining the ethmoid labyrinth).
The main danger of polyps in the nose is that in the absence of treatment they are able to shorten the patient's life by about 6 years. The fact that to facilitate nasal respiration in polyps of any vasoconstrictor drops can not. The person for this reason has to breathe through the mouth, which greatly exacerbates the risk of various respiratory diseases, but also increases the likelihood of developing asthma.
The content of the article:
The symptoms of nasal polyps
Symptoms that indicate the presence of polyps in the nasal mucosa, the following:
- Nose breathing is either difficult, or even impossible. The person experiences a constant feeling of stuffiness. Such difficulties stem from the fact that mucosal tissue grew and blocked (either fully or partially) respiratory clearance of the nasal passage;
- When joins secondary infection, the mucous glands begin to work hard. For this reason, the patient increases the production of mucus, in severe cases it may be purulent admixture;
- A person usually begins to sneeze. This defensive reaction is due to the fact that the polyp irritate the cilia, covering the walls of the nasal mucosa. They accept it as foreignbody and pomocu sneezing trying to clear the nose;
Headaches. They are caused by a number of factors. First, the body, including the brain, begins to suffer from lack of oxygen. Secondly, greatly expanded education put pressure on nerve endings, causing natural pain response. Thirdly, the headache may be due to the inflammatory process occurring in the paranasal sinuses (sphenoid, maxillary, ethmoid labyrinth or in the frontal sinus);
- Violations of olfactory function. At much the expanded polyps may be complete loss of sensitivity to smells. This symptom is due to the fact that proliferating connective tissue disrupts the receptors responsible for the perception of flavor;
- Large nasal polyps can affect taste sensations of the patient and even become the cause of unpleasant taste in the mouth;
- In childhood education can cause the formation of malocclusion. If the polyp appears in the first year of life, then this complicates the feeding, as the child cannot suck and swallow food. As a result, the baby suffers from chronic malnutrition, which leads to weight loss and General malnutrition;
- The voice changes, development of nasal. Due to the fact that the flow of air via the nasal passages is disrupted, the patient begins to speak in the nose. Furthermore, it is known that the nose is the organ that is directly involved in the formation of speech sounds.
The severity of symptoms depends on what stage is the growth of:
In the first stage, the outgrowth of a small size, so it covers only the upper nasal septum. The patient has slight nasal congestion, which is often perceived as normal SARS. However, in the initial stages polyps may trigger the development of otitis, tonsillitis or adenoiditis;
- The second stage of nasal polyposis is characterized by further growth of connective tissue. The patient begins to experience difficulties with sense of smell, changing his voice acquired a twang. When education comes to the auditory tube becomes distorted speech, deteriorating hearing. If at this stage not to ask for help, pathological changes can be permanent;
- The third stage is characterized by completethe overlap of the nasal passage, symptoms of gaining full force. Upon accession of infection occurs a rise in body temperature. In addition, patients suffer from headaches, fatigue. Quality of life significantly reduce the constant discharge from the nose.
Causes nasal polypsBefore turning to the enumeration of the causes leading to the appearance of polyps, you should understand the mechanism of their formation. When the human body gets the virus or bacteria, the reproduction of infectious agents. This causes exfoliation of the cells lining the nose. The person begins to suffer from congestion, difficulty breathing, profuse nasal secretions. If the immune system is functioning normally, and the person receives adequate treatment, about a week later there comes a full recovery.
If chronicization process fails in the work of local immunity and mucosa to enhance resistance to disease, tends to increase the occupied area. The only possibility is to implement – to begin to grow and harden. Most often this process occurs in the paranasal sinuses. At some point, the dividing cells becomes a little space, and they go into the nasal cavity and forms a polyp.
Therefore, the specific reasons leading to widening of the nasal mucosa, are:
- Infections and colds, which are accompanied by a runny nose and appear often enough;
- Diseases such as bronchial asthma, cystic fibrosis, young's syndrome, syndrome of Cerca-Strauss, nasal mastocytosis syndrome Kartagener, intolerance to aspirin;
- Hereditary polyposis;
- Too narrow nasal passages, abnormalities in the structure of the nasal septum;
- Pathological malfunctions of the immune defense.
That is, nasal polyps is a disease with multiple causative factors, which simultaneously affect the anatomy of the nose, chronic inflammation of his sinuses and allergies.
What is the danger of polyps in the nose?
The danger of proliferation of the nasal mucosa primarily lies in the development of complications. Whennatural breathing through the nose does is not difficult, is the moistening and warming of air entering the lungs. It also removes dust particles that remain on the mucous membrane, and then naturally excreted. Polyps prevent air to pass freely in the nasal path, forcing the person to breathe through the mouth.
As a result, the air does not have time to properly warm up, which causes diseases such as:
Due to the fact that there is a violation of the natural communication between the nasal sinuses, the patient suffers from chronic sinusitis.
The more sprawl, the more it presses on the blood vessels of the nasopharyngeal tissues, causing an inflammation of the tonsils and the formation of adenoids, enlarged Palatine tonsils with symptoms of angina. Also poor circulation can lead to the development of the clinic chronic tonsillitis. With regard to violations on the part of the auditory tube, increasing pressure on it leads to the development of otitis media or Eustachian.
Diagnosis of a polyp in the noseSuspect that the patient has a polyp in his nose, the doctor may nasal voice, even if the patient does not complains of difficult nasal breathing. If the polyp is formed in childhood, then this doctor will tell himself the appearance of a child. These children are constantly opened mouth, the lower jaw droops, nasolabial folds are smoothed triangle.
To clarify the diagnosis is carried out rhinoscopy, during which the doctor examines the nasal cavity using a special mirror. Polyps fleshy externally, constitute a racemose or solitary growths.
To assess the stage of their development is sometimes appointed CT of the paranasal sinuses. This procedure is required to undergo to patients that scheduled for surgery. The results of imaging will give information to the surgeon about the volume of future intervention. If the CT scan is for any reason impossible, then the patient should undergo x-rays.
In addition to identifying the existence of polyps, should be ruled out or confirm concomitant infection. This takes the cultures from the nose and throat, is pharyngoscopy, otoscopy and microlaryngoscopy. Also needed blood samples for clinical analysis. Ifa suspected allergic nature of the growths, then it is reasonable to conduct Allergy tests.
All diagnostic procedures are prescribed by the otolaryngologist.
Answers to common questions about nasal polyps
- Do I need to remove polyps in the nose? Polyps terrible its complications, such as sleep apnea, asthma, chronic sinusitis. Surgery is the only way to remove polyps from the nose. However, it is necessary to highlight the modern ways of removal, like laser burning and endoscopic resection shaver. With regard to conservative therapy, it is aimed primarily at addressing the causes of proliferation of the nasal mucosa. Treatment acts as a preparatory stage before operation;
- Is it possible to heat the polyps in the nose? Warm polyps is impossible. It is not only completely ineffective procedure, but also to some extent even dangerous, as the high risk of burns to the mucous membrane. Don't confuse warming up with removal of polyp by the thermal method with the help of quartz fibers. This procedure is performed by a physician in a hospital;
- Is it possible to cure nasal polyps without surgery? Treatment without surgery can be aimed at prevention of recurrence of polyps, or if there is a specific contraindication to surgical intervention. However, it is important to understand that if a polyp is formed in the nasal cavity, then no surgery itself, he can not.
Treatment nasal polypsConservative therapy of nasal polyposis is designed, primarily, to eliminate the factors that have an impact on the increasing proliferation of the mucous membrane. It can be a whole range of treatments offered by modern medicine: laser therapy, injection treatment, therapeutic warming, the medication.
To choose the optimal treatment regimen can only doctor surgeon-otolaryngologist. Sometimes you need an additional consultation of the allergist-immunologist.
So, conservative treatment is reduced to:
- The exclusion of the influence of factors provocateurs that have a positive impact on the growth and thickening of the mucous layer. It is important to avoid contact with all kinds of allergen (household, pollen, medicinal, professional);
- Eliminate all infectious-inflammatory processes in the nasopharynx;
- The diet with the exception of foods-allergens, as well as spicy and salty. Banned coffee and alcohol. It's advisable to abstain from taking NSAIDs, and of food containing preservatives, dyes, and salicylates;
- Regular lavage of the nasal cavity using saline solutions, for example, Dolfin, Aqua Maris, Marker, Gudivada, Physiomer, Allergol Dr. Tissa, Otrivin Sea;
- Special exercises for restoration of nasal breathing by Strelnikova method Buteyko, self massage ternary nerve;
- Anti-allergic and immune medication.
Another method of treatment of polyps without surgery is a thermal effect where the education is heated through a quartz fiber introduced into the nose. While the temperature reaches 70 degrees, which leads to rejection of polyps after about three days. If the patient is unable to vismarkt them yourself, then the doctor will remove all loose polyps with tweezers.
This treatment is advantageously carried out in the presence of the following contraindications:
The treatment is applied, if any surgical intervention is completely eliminated. In high doses the patient receives inside corticosteroids for 3 weeks. Either they are administered injection directly into the growths. However, this method of treatment of nasal polyps at high risk of recurrence.
In addition, hormone therapy is dangerous for its complications, including addiction, immunosuppressive effect, inhibition of the adrenal glands. Result from the use of hormonal agents occurs very rapidly, but after a while the patient will again feel the deterioration. If you practice this therapy often, the human health will be undermined.
You should elaborate on the treatment of nasal polyposis hormones. This is usually done by doctors use the prednisone. Its action is based on the reduction in the rate of cell division that does not allow the mucous membrane to SAG further, and the growth collapses over time. This technique is called "drug polypotomy". However, to achievepositive effect, the patient will need to take a very high dose of prednisolone daily and for a long time. From polyps it will save, but will lead to other serious health problems, such as stomach ulcers, obesity, drop in immune strength, etc.
So there is another option of polypotomy using hormonal methods is introduced directly into the growth. This way you can achieve the destruction of the polyp and to avoid serious complications from taking the hormones inside. The choice of a particular drug and its dosage is for each patient individually.
Patient doing prior to two injections with an interval of two weeks. This contributes to the withering away of overgrown tissue of the mucous membrane, and is removed from the body during bismarckiana. If the technique of the medical polypotomy was not broken, and the dosage and the drug itself was chosen correctly, it will lead to a significant improvement of health condition of the patient after 30-60 days.
Well-written rehabilitation program will delay the next relapse of the disease for several years. Unfortunately, completely eliminate the risk of relapsing mucosa with the help of hormones is impossible.
Removing nasal polyps with laserBurning the growths with a laser beam is one of the modern methods of surgical intervention. It is performed using laser equipment, and endoscope with the camera.
Among the advantages of laser treatment:
- The speed of operation;
- The absence of pronounced pain;
- No risk of development of bleeding during surgery;
- No risk of infection;
- Visual inspection of the performed action;
- Low probability of disease recurrence;
- Short recovery period (no more than 4 days);
The possibility of outpatient procedure.
Among the disadvantages of treatment of nasal polyps with a laser:
- The inability to eliminate multiple growths;
- The impossibility of opening of sinuses and removal of polyposes tissue inside them that could trigger a relapse.
Indications and contraindications to the removal of nasal polyps by laser
Among the contraindications to laser therapy:
- Obstructive bronchitis;
- Multiple polyphoniegrowths;
- The period of gestation of the child;
- The flowering season of plants.
The indications for the intervention is a single polyp of the nose with accompanying symptoms. Additionally, low injury rate gives you the opportunity to carry out the operation in patients suffering from bronchial asthma.
What is the procedure?
In the day when the procedure is carried out, the patient must abstain from food. The operation is as follows: the doctor injects a local anesthetic, then to the existing sprawl supplied endoscope equipped with a camera and laser equipment. The beam heats up the cells of the polyp, and they begin to evaporate. Bleeding not caused by immediate sealing of blood vessels (coagulation).
After the operation is completed, the person remains under medical supervision for another day, although sometimes it is released home after only a few hours. For 4 days he must visit the doctor to control the process of the healing of the nasal mucosa. During the recovery period it is necessary to exclude alcohol, a visit to the steam rooms and baths, and to refrain from vigorous physical activities to minimize the risk of postoperative bleeding.
What is the procedure for laser removal of nasal polyps?
In the specific clinic cost of laser removal of nasal polyps will vary. But the average price is 16,000 rubles, which makes the operation very affordable for most people.
Endoscopic removal of polyps in the nose shaverSurgery of the sinuses using functional endoscope (Functinal Endoscopic Sinus Surgery) is a new technology, which involves the most modern endoscopic equipment. Thus, surgeons were able to exercise less traumatic intervention with extremely low risk of complications. This procedure of education will be removed from the body completely, which reduces the likelihood of re-growth on 50%. In addition, healthy tissues are not affected at all.
Deciding on such a procedure, preference should be given to endoscopic FESS. This operation allows the navigation control operation of the shaver (or microdebrider). Only this approach allows us to clean out the cavity of a trellised labyrinth completely. The importance of global purification is to minimize the risk of relapse. After all, if there are areaspolyposes fabric, then after a short time (from 3 months to half a year) it will grow again. As a result, new interventions and financial losses. In addition, you should pay attention to existing doctor's experience with such modern equipment.
There are several options of intervention with the use of endoscopic equipment:
- Endoscope + tools (not allows you to clean the smallest cells, as well as those which are deeply located);
- Endoscope + shaver;
- Endoscope + shaver + navigation (optimal method).
However, despite the benefits of such an intervention, it is impossible to implement, if found:
- Serious violations of the internal organs;
- Infection in the acute phase;
- Exacerbation of allergies, asthma or obstructive bronchitis;
- Coronary artery disease or heart failure;
- Hypertension, a serious ailment require some delay intervention.
The advantages and disadvantages of the method
Among the advantages of endoscopic treatment of nasal polyps with a shaver:
- The lack of necessary incisions, the endonasal procedure is performed;
- Full control of the doctor's own actions;
- Gaining access to inaccessible areas of the nose;
- The lack of trauma to healthy tissue;
- No bleeding;
- Rapid onset of relief, which claim to 80% of patients;
- The operation in a hospital, a short stay in the hospital (from 3 days to a week).
Among the disadvantages of the procedure:
- The inability to resolve the true cause of the overgrowth that causes the risk of its recurrence (in 50% of cases).
What is the procedure?The field, where it will undergo the intervention, viewed by the doctor on the monitor. To implement the procedure, the doctor will need:
- Sam shaver (debrider or microdebrider), which will involve the growth and cut it off at the base;
- An optical endoscope having different tilt angle;
- Nasal mirror.
The procedure will require the injection of a patient in a stateGeneral anesthesia, as this allows full disclosure of anastomosis, as well as improving drainage. Although the recovery time after the operation a few elongated compared to other methods of removing polyps, but the risk of recurrence in this case is much lower. If it occurs, is considerably delayed in time.
When you start to act anesthesia, the patient in the mouth is inserted the special plastic tube, allowing him to keep breathing. The sinuses are revealed with the help of special tools, then they removed all the polyps and modified tissue. When performing FESS, there is a great opportunity to correct the nasal septum, if it is curved, as well as to carry out biopsy tissues. At the end of the intervention the nasal cavity overlaps with a cotton swab. They can be removed after 12 hours.
- The upcoming intervention requires a specific preparatory program. You should take all the required tests a doctor and undergo a CT scan of the sinuses, in addition, can be assigned to coagulation, blood biochemistry and the clinic. It is important to determine whether preliminary endoscopic examination, which will give the surgeon information about the upcoming operation and optimize it.
- A week before the intervention. In severe polyposis patient is prescribed a taking prednisone for 7 days. Daily dose is 40 mg. If there is active infection, then it is subject to elimination. It is important to exclude the admission of non-steroidal anti-inflammatory drugs, aspirin and vitamin E. This is due to the fact that they have a negative impact on the speed of blood clotting.
- The day before surgery. The patient can have dinner, but the food should not be heavy. When the moment of intervention will remain 6 hours, any food and drink fall under the ban. If thirsty, you can rinse the oral cavity.
The postoperative period
At this time, in the foreground, correct hygiene of the nasal cavity. The fact that after the intervention reduced the activity of ciliated epithelium, mucosa is damaged and unable to produce protective secret in full. It becomes a favorable environment for bacteria. After removing the wool in the nose are formed crusts composed of blood and plaque of fibrin.
To remove only the peel, which is ahead of the nose, it is strictly forbidden to blow your nose or eat hot food. About success is evidenced by headache and soreness in some facial parts. The sense of smell canto recover for 30 days.
In the postoperative period may develop complications: bleeding, recurrence of polyp, the formation of adhesions and the accession of infection.
To prevent re-expansion of the tissue, rinse the nose with salt solutions, which were listed above, and also use antihistamines, including loratadine, claritin, Cethrin, Zodak, Erius, etc.
In addition, it is necessary to use aerosol preparations based on hormones:
- Almost four years;
- To lower blood pressure mother;
Equally important for the prevention of recurrence diet. This is especially true in flowering plants. Therefore, this period should be discarded from human consumption of potentially dangerous products, such as nuts and seafood.
The patient necessarily need to visit the attending ENT physician every 12 weeks. This should be done throughout the year. In addition, observation is indicated allergist-immunologist.