Nasal polyps are noncancerous (benign) growths that occur in the nose. They are seen in about 20 percent of people who have chronic rhinosinusitis.
You may not notice these growths at first. As they get bigger, nasal polyps can cause recurring postnasal drip, runny nose, and congestion, as well as pain and tenderness in your cheeks and forehead.
Nasal polyps may also lead to frequent sinus infections and reduced sense of smell.
The only way to completely get rid of nasal polyps is with a type of surgery called a polypectomy. Even with surgery, nasal polyps are notorious for growing back after removal.
Curious about whether your own nasal polyps may grow back after surgery?
Read on to learn about the statistics, risks, and other important information to discuss with your doctor.
Nasal polyps may be managed with medications. Steroid sprays are often the first treatment prescribed to help reduce swelling (inflammation) and polyp size.
Surgery is sometimes recommended if polyps are so large that they can’t be managed with medications, and you continue to experience uncomfortable symptoms.
Despite surgical removal, nasal polyps will likely grow back. It’s important to keep track of your symptoms and continue to see your doctor for follow-up exams.
Nasal polyps are soft, inflamed tissues that form inside the nasal and sinus cavities. They can grow so large that they make it difficult to breathe.
The polyps themselves are distinct from healthy mucous membranes lining the nose. The goal of surgery is to remove the polyp tissue while leaving as much of the normal mucus membranes as possible.
While there’s no exact known cause, nasal polyps are thought to stem from long-term inflammation. This may be related to a variety of conditions, such as:
- chronic rhinosinusitis
- cystic fibrosis
About 30 percent of adults with asthma and nasal polyps have aspirin-exacerbated respiratory disease (AERD).
People with this chronic medical condition have breathing problems (sinus pain, coughing, wheezing, etc.) when they’re exposed to aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs).
Most require daily treatment to help manage symptoms but still have nasal polyps even when they entirely avoid NSAIDs.
Nasal polyps may return after surgery due to the underlying inflammation that caused them to form in the first place.
Clinical research has revealed a high recurrence of nasal polyp growth after surgery.
However, 37 percent required a future surgery for polyp removal. People who had been diagnosed with allergic disease were significantly more likely to require revision surgery.
Another 2017 study of patients who underwent the same surgery between 2004 and 2015 found that
Some participants even noted worse symptoms than before. Risk factors for regrowth included a history of previous sinus surgery and severity of nasal polyps.
Managing inflammation-related conditions such as allergies and aspirin sensitivity before surgery helps ensure the best outcome possible.
This might involve strategies such as taking:
- allergy medications
- allergy shots
- aspirin desensitization therapy
The exact timeline for nasal polyp regrowth cannot be predicted. Research shows that the process may take several months.
For example, the aforementioned 2017 study found that
Other research has noted improved symptoms in patients after surgery with few needing additional procedures within the first 2 years. It’s worth noting that just because polyps regrow doesn’t mean the same symptoms will also return.
Additional treatment is recommended after surgery to help maximize the benefits of surgery, regardless of whether you’re currently having symptoms.
Some medications may also help stop the polyps from getting larger and even reduce the chances you’ll need a second surgery.
Steroid nasal sprays
The most common treatments for nasal polyps even after surgery are nasal steroid sprays. These sprays are considered safe to use long term.
Using steroid sprays may help decrease the size of nasal polyps. They may also help reduce your symptoms and the odds you’ll need additional surgery.
Doctors also usually recommend that patients regularly use saline nasal irrigation or nasal irrigation with steroids, such as budesonide, to help keep nasal passageways clear and reduce inflammation.
Oral steroids are sometimes recommended in short-term dosages only. These help reduce inflammation and polyp size. Oral steroids carry a higher risk of side effects compared to nasal sprays.
If you also have allergies, your doctor might recommend over-the-counter nasal sprays with fluticasone (Flonase, Xhance). These may help alleviate your symptoms and decrease inflammation in your nose.
In addition to nasal steroid sprays, another option for people with allergies or asthma is an oral prescription leukotriene modifier called montelukast (Singulair).
If you have chronic rhinosinusitis with nasal polyps (CRwNP), your doctor may recommend injections of the biologic medication dupilumab (Dupixent) or omalizumab (Xolair).
These medications were originally created to treat asthma and allergies. The Food & Drug Administration (FDA) has approved them to treat CRwNP.
Research suggests that they help:
- reduce polyp size
- improve symptoms
- reduce the need for oral steroids and future surgery
Oral antibiotics may be prescribed if you have recurring nasal polyps that cause bacterial sinus infections. These are not long-term solutions, and they don’t help decrease inflammation or directly shrink polyps.
If you have chronic bacterial sinus infections, your doctor may recommend using an antibiotic nasal rinse. This allows the antibiotic to clear up the infection without having an effect throughout the entire body.
Sometimes your doctor may recommend a less invasive nasal polyp removal procedure known as an intranasal polypectomy. It’s performed on an outpatient basis and involves removing the polyps with a suction device.
This procedure is usually used in people with polyps that are obstructing the nasal passages. One study published in 2020 found that nearly
The downside is that this procedure only addresses smaller polyps that are closer to the nostrils. It cannot treat polyps located deeper in the nasal or sinus cavities.
Drug-eluting stents are devices that are inserted into the sinuses following endoscopic sinus surgery. They slowly release corticosteroids into the nasal passageways to help decrease inflammation and improve wound healing. They dissolve on their own with time.
The American Rhinologic Society recommends the use of drug-eluting stents after sinus surgery to help:
- slow the regrowth of polyps
- lengthen the time until future surgery is required
- limit the need for oral steroids
Nasal polyps are commonly seen in people with chronic rhinosinusitis. While benign, these growths can cause uncomfortable symptoms that affect your daily life, including congestion, runny nose, loss of smell, and more.
Surgery is the only way to get rid of nasal polyps completely and is frequently recommended for larger polyps. It’s likely that polyps will eventually return months to years after they’ve been removed.
You may need to take prescription medications after surgery to help decrease inflammation and polyp size.
Common options include:
- nasal steroid sprays
- saline nasal rinses
- allergy medications
While these medications can’t replace surgery, some may help you avoid a second operation.