Nasal Polypectomy Surgery

Why Do People Get Nasal Polypectomy Surgery?

Getting a nasal polyp removal surgery can have several reasons, but it is primarily done to resolve issues arising from the nasal polyps, thereby improving the quality of life. The main indications are briefed below:

• Chronic nasal obstruction: A person may find it difficult to breathe if the polyps start causing obstruction in the nasal passages. This can lead to mouth breathing, which can then result in dry mouth and throat.
• Recurrent sinus infections: Obstruction in the drainage of the sinuses due to nasal polyps can cause recurrent or chronic sinus infections. This can cause pain, mucus production as well as further inflammation and polyp growth.
• Reduced sense of smell and taste: Polyps can block the olfactory area, thereby affecting the olfactory senses and reducing or completely eliminating the sense of smell. This can further diminish the sense of taste too.
• Sleep disturbances: Nasal obstructions can also lead to sleep apnea and snoring, affecting the quality of sleep and enhancing daytime fatigue.
• Improving medication efficacy: Sometimes, nasal polyps can block medications like nasal corticosteroid sprays from reaching the sinus areas and nasal passages. For the treatments to work efficiently, removal of the polyps is needed. 
• Relief from headaches: Lastly, nasal polyps are often associated with chronic sinus pressure and infections, which can lead to frequent headaches.

Surgery is recommended when conservative treatments like corticosteroids (nasal or oral sprays), antibiotics, or antihistamines fail to give symptomatic relief. It may also be considered when the polyps become large enough to cause significant obstruction and discomfort. 

Different Types Of Nasal Polypectomy Surgery

The different types of nasal and sinus polyp removal surgery can be summarized below:

Every type of nasal polypectomy comes with its set of benefits and considerations, which vary with the polyp growth, overall health, and anatomical concerns.

During Surgery

Nasal polypectomy surgery may vary with the chosen technique and patient needs, however, it is typically as follows:

• Anesthesia: Usually the patient is administered general anesthesia. Local anesthesia with sedation might be used for less invasive procedures.
• Accessing the nasal passages: The nasal passages are accessed through the nostrils, so there’s no need for external incisions. An endoscope is used in this minimally invasive approach, which is a thin flexible tube with light and camera.
• Visualization: The surgeon uses the endoscope to clearly view the inside of the sinuses and nasal passages on a monitor. This helps in the precise removal of the polyps and other necessary corrections.
• Removal of polyps: The surgeon uses specialized instruments such as forceps, microdebriders, or suction devices to remove the nasal polyps. The polyps may be cut away from the nasal mucosa or gently detached from the underlying tissue.
• Addressing other issues and ensuring drainage: Any other existing conditions such as deviated septum or enlarged turbinates may also be managed simultaneously. The openings of the sinuses may be enlarged to improve drainage and reduce the chances of sinus infections in the future.
• Closure: Nasal polypectomy usually does not require any closure as there are no incisions involved. Nasal packs may be used to control bleeding and promote healing.

After the procedure, the patient is taken to the recovery room for further monitoring. The patient is usually allowed to go back home the same day, however, in some cases, s/he might be instructed to stay back for further monitoring. 

After Surgery (Recovery And Outlook)

Here’s what you can expect during the recovery phase.

• Recovery room: The patient is monitored in a recovery room after the procedure. Your vital signs such as blood pressure and heart rate are monitored during this period.
• Pain management: Any pain and discomfort after the procedure can be managed with prescribed pain medications.  
• Nasal packing: In cases where nasal packing is placed, it is removed a few days after the surgery. 
• Instructions: You will receive certain post-operative instructions such as to avoid blowing your nose, to take sufficient rest, and avoid strenuous activities for a few days.
• Follow-up appointments: Make sure that you attend all the follow-up appointments scheduled by the surgeon in order to track your progress in healing and ensure that you 

The success rate of nasal polypectomy is high and its entire results take several weeks to months to show. 

Nasal Polypectomy - Risks / Benefits

Nasal polypectomy has its own set of benefits and disadvantages. They are as follows:

Risks:

• Bleeding during or after surgery
• Infection after surgery typically managed with antibiotics
• Recurrence of polyps even after a successful procedure
• Anesthesia complications like allergies
• Damage to the surrounding structures like the eyes and the base of the skull
• Damage to olfactory nerves, altering smell perception
• Changes in voice

Benefits:

• Improved breathing due to improvement in airflow through the nasal passages
• Reduced symptoms like nasal congestion, facial pain, loss of smell, and frequent infections
• Enhanced quality of life, improved sleep, and better exercise tolerance
• Reduced risk of recurrent sinus infections due to improved drainage

It is important to understand both risks and benefits before undergoing the polyp removal nasal surgery to make informed decisions.