are pale, edematous, mucosally covered masses commonly seen in patients with allergic rhinitis
They may result in chronic nasal obstruction and a diminished sense of smell
In patients with nasal polyps and a history of asthma, aspirin should be avoided as it may precipitate a severe episode of bronchospasm, known as triad asthma (Samter triad)
Such patients may have an immunologic salicylate sensitivity
Use of topical intranasal corticosteroids improves the quality of life in patients with nasal polyposis and chronic rhinosinusitis
Initial treatment with topical nasal corticosteroids (see Allergic Rhinitis section for specific drugs) for 1–3 months is usually successful for small polyps and may reduce the need for operation
A short course of oral corticosteroids (eg, prednisone, 6-day course using 21 [5-mg] tablets: 6 tablets [30 mg] on day 1 and tapering by 1 tablet [5 mg] each day) may also be of benefit
When polyps are massive or medical management is unsuccessful, polyps may be removed surgically
In healthy persons, this is a minor outpatient procedure
In recurrent cases or when surgery itself is associated with increased risk (such as in patients with asthma), a more complete procedure, such as ethmoidectomy, may be advisable
In recurrent polyposis, it may be necessary to remove polyps from the ethmoid, sphenoid, and maxillary sinuses to provide longer-lasting relief
Intranasal corticosteroids should be continued following polyp removal to prevent recurrence, and the clinician should consider allergen testing to determine the offending allergen and avoidance measures
Biologic therapies with interleukin-specific blocking antibodies are currently in preclinical and clinical trials and may be a valuable means of controlling nasal mucosal polyps in the future
