Description

• Nasal polyps are non- neoplastic masses of oedematous nasalor sinus mucosa. It typically presents with postnasal drip, bilateral nasal obstruction, and impaired olfactory function
• Persistent stuffy or blocked nose, nasal congestion, loss of smell or decrease in sense of smelltogether with snoring is indicative of nasal polyps
• They are divided into two main varieties - Ethmoidal polyp and Antrochoanal polyp
• Ethmoidal polyp – in the ethmoidal sinuses
• Antrochoanal polyp (Killian’s polyp) - arises from the mucosa of maxillary antrum near its accessory ostium, comes out of it and grows in the choana and nasal cavity. It has three parts- Antral, which is a thin stalk; Choanal, which is round and globular ; Nasal, which is flat from side to side

Types

Ethmoidal polyp

Symptoms

• Multiple polypi can occur at any age but are mostly seen in adults
• Nasal stuffiness- leading to total nasal obstruction
• Partial or total loss of sense of smell
• Headache - due to associated sinusitis
• Sneezing and watery nasal discharge
• Mass protruding from the nostril

Signs

• On Anterior rhinoscopy, polypi appear as smooth, glistening, grape-like masses often pale in colour

Antrochoanal polyp

Symptoms

• Unilateral nasal obstruction
• Voice may become thick and dull due to hypo nasality
• Nasal discharge, mostly mucoid

Signs

• As the antrochoanal polyp grows posteriorly, it may be missed on anterior rhinoscopy

Investigation

• Clinical examination
• CT - Paranasal sinuses – determines exact location and extent of polyps
• Nasal endoscopy – bilateral grey polypoid mucosa hypertrophy

Treatments

Conservative

• Steroids

Surgical

• Polypectomy
• Ethmoidectomy
• Endoscopic sinus surgery

Ayurvedic Treatment

• Allergy plays major role –immunity boosters can be used
• Complication of chronic sinusitis – Sinusitis Rx

 Internal Medicines

• Varunadi kashaya
• Nirgundyadi kashaya
• Dusparshakadi kashaya
• Kanchanara guggulu
• Mukkadi gutika
• Indukantha gritha
• Varanadi gritha
• Haridra Khanda
• Vyoshadi vataka
• Dashamoola hareetaki
• Suranaavaleha

Procedures

• Lepa - Rasna jambeera in Nasal obstruction
• Nasapichu - Nasarshas taila, Guggulu tiktaka gritha
• Theekshna lepa - white Gunja over polyp
• Kshara karma - Gunja ksharam ( 1-3 sittings)

Department

Salakya - ENT