Chronic nasal obstruction, or a stuffy nose, is often caused by enlargement (hypertrophy) of the inferior nasal turbinates. Chronic nasal obstruction can impair normal breathing, forcing patients to breathe through the mouth and often affects their daily activities. Enlarged turbinates and nasal congestion can also contribute to headaches and sleep disorders such as snoring and obstructive sleep apnea, as the nasal airway is the normal breathing route during sleep.

There are various reasons for turbinate hypertrophy:

• Allergies
• Environmental irritants (such as cigarette or cigar smoke)
• Persistent sinus inflammation
• Aging process
• Congenital variations
• Pregnancy or other hormonal changes

It is common to have a nasal septal deviation in addition to inferior turbinate hypertrophy. Turbinates tend to be smaller on the side of the septal deviation and larger on the side opposite from the deviation. This makes sense because the body often tries to compensate for anatomic differences. When the septum deviates to one side of the nasal cavity, it takes up more space and the body adjusts by making the turbinates on that side smaller. In the other half of the nasal cavity, there is more space available and thus the turbinates there are larger. Deviation of the nasal septum and/or enlargement of turbinates are two of the main causes of nasal obstruction.

Allergy or irritant-related turbinate hypertrophy usually responds well to medical treatment. In treating the underlying cause, the turbinate swelling is often reduced and the problem is solved. Unfortunately, long-term chronic swelling can become irreversible and unresponsive to medical therapy. In these situations, turbinate reduction surgery may be required to help reduce the symptoms.

Ideally, the nasal septum is perfectly straight and precisely in the middle of the nose, making each side of the nasal cavity the same size. However, the nasal septum often deviates from the midline of the nose; this condition is known as a deviated nasal septum. More than 80 percent of the population has some degree of nasal septal deviation or crookedness.

At birth, the nasal septum is usually straight and remains straight throughout childhood. However, as a person ages, there is a tendency for the septum to bend to one side or the other. Sometimes the septum is bent as a result of birth trauma. Trauma plays a major factor in producing septal deviation during childhood or adult life; however, often there is no history of injury to account for the irregular septum.

Sometimes the deviation is severe enough to cause nasal obstruction and affect breathing. Chronic nasal obstruction can contribute to headaches, sleep disorders such as snoring and obstructive sleep apnea, and impair normal breathing, forcing patients to breathe through the mouth and often affecting their daily activities.

Deviation of the septum and/or enlargement of turbinates are two of the main causes of nasal obstruction. A deviated septum can be straightened with an operation called a septoplasty.

An allergy is an overreaction of the body's immune system to a typically harmless substance. A person without allergies will have no reaction to such substance, but when a person who is allergic to the substance encounters it, the body reacts by releasing chemicals which cause allergy symptoms. Nasal allergy symptoms can be triggered by substances such as pollen, mold, dust mite, animal dander and environmental irritants such as smog and climate factors.

Nasal Allergies occur in up to 30% of adults and up to 40% of children. In the US, the prevalence of allergies has been increasing since the early 1980s. Experts estimate that allergies affect as many as 40 to 50 million Americans. Pollen allergies are one of the most common chronic conditions in the US.

During an allergic attack, antibodies, primarily immunoglobin E, attach to mast cells (cells that release histamine) in the nose, lungs, skin, and mucous membranes. Once immunoglobin E connects to the mast cells, a number of chemicals are released. One of the chemicals, histamine, increases secretions, promotes itching, and causes the membranes to swell.

Symptoms of nasal allergies may include:

• Sneezing
• Runny nose
• Itchy nose and eyes
• Pressure in the nose and cheeks
• Nasal congestion
• Post-nasal drip
• Ear fullness and popping
• Allergic shiners (dark circles under the eyes)
• The "allergic salute," a line across the nasal bridge caused by an upward rubbing of the palm of the hand on the nose.

Treatment:

It is common for patients not to seek treatment for their nasal allergies because they consider their symptoms to be an annoyance that they just have to tolerate. Although there is no cure for nasal allergies, there are many safe and effective treatment options that can help manage nasal allergy symptoms. Each treatment has benefits and drawbacks.

Avoid Allergies:

Although not always possible or practical, a great way to avoid nasal allergy symptoms is to try to steer clear of the substances that trigger the allergies. Below are some examples:

• Reduce the amount of pollen and other allergens in your hair and skin by showering before bedtime.
• Limit pollen exposure on dry, windy days by keeping windows and doors shut.
• Reduce the amount of mold in the house by removing houseplants and frequently cleaning shower curtains, bathroom windows, damp walls and areas with dry rot and indoor trash cans. In addition, you can reduce the amount of mold in the house by avoiding carpeting bathrooms or other damp rooms of the home and using mold-proof paint instead of wallpaper.
• Cat or dog dander often collects in the house dust and takes 4 weeks or more to subside. Reduce the amounts of pet dander in the home by using allergen-resistant bedding, bathing your pet frequently, and using an air filter.
• Reduce dust and dust mites in the home by:

Medical Treatment:

• Antihistamines. Antihistamines help block the action of histamine, the substance produced by our bodies during an allergic reaction. They help reduce the sneezing, runny nose and itchiness symptoms that allergies cause. Although antihistamines are most useful when used prior to exposure to allergens, they are also effective in reducing symptoms once the body is exposed.
  There are many antihistamines to choose from. They come in the form of pills and nasal sprays, and some are available over-the-counter, while others require a prescription. Side effects of antihistamines may include drowsiness and dry mouth. The extent of these symptoms may vary depending on the type of antihistamine and the dose used.
  
• Saline Nasal Sprays: Over-the-counter saline nasal sprays help reduce nasal congestion. They are effective, safe and nonirritating. Saline nasal sprays provide moisture to the nasal passages, especially during cold or dry seasons. When the nasal passages are dry, stagnation of mucus and mild nasal crusting may occur. Thus, inhaled allergens may not be cleared from the nasal passages in a timely fashion. Saline sprays clean the nasal passages of allergens, crusts and mucus and also help the natural cleaning system of the nasal passages.
• Decongestants. Decongestants fight nasal congestion by temporarily constricting the blood vessels. By reducing the size of the blood vessels, the nasal mucosal swelling, and therefore the nasal congestion, is reduced. Decongestants are available in pill form as well as nasal sprays. Please be aware that over-the-counter nasal decongestant can cause a "rebound effect" when used longer than the recommended period. This results in worsening of the nasal congestion after the medication has been stopped. In addition, decongestant pills may increase blood pressure and heart rate. Decongestants should not be taken without first checking with a physician if the patient has heart disease, high blood pressure, prostate problems, diabetes, or thyroid problems.
• Inhaled Nasal Steroids. Inhaled nasal steroids, or corticosteroids, are inhaled nasal sprays that treat nasal allergy symptoms. They do not cause a "rebound effect." They reduce the reaction of the nasal tissues to inhaled allergens. This helps relieve the swelling in the nose, thus reducing the congestion. It may take up to a week to notice the benefits of these steroid sprays.

Symptoms:	Sneezing	Runny Nose	Itchiness	Facial Pressure	Nasal Congestion	Post Nasal Drip	Ear Congestion
Antihistamines	•	•	•			•
Decongestants				•	•		•
Inhaled nasal steroids	•	•	•	•	•	•	•

 

Allergy Shots (Immunotherapy):

The goal of allergy shots is to "train" the immune system over time to be better able to tolerate the allergens that trigger the symptoms. Allergy testing is used to help identify the specific allergens that are causing the reactions. Allergy shots contain small amounts of these allergens and are given on a regular schedule so that the body gets used to the allergens and no longer overreacts to them.

A common cold is an infection of the upper respiratory tract. Although it is usually harmless, it certainly may not feel that way. Since there are more than 200 viruses that can cause a common cold, the symptoms tend to vary greatly. Most adults suffer from a common cold two to four times per year. Children, especially preschoolers, may have a common cold as many as six to ten times annually.

The rhinovirus is the most common virus causing the infection, and it is highly contagious, meaning it can be easily spread from one person to another. A cold virus enters the body through the mouth or nose and can spread through droplets in the air when someone who is sick coughs, sneezes or speaks to you. A cold virus can also be spread by direct contact with someone who has a cold or by using shared objects, such as telephones, toys, or utensils. Touching the nose, mouth, or even eyes after such contact or exposure, may lead to a cold.

Symptoms:

Nasal allergies and colds share many of the same symptoms, which may make it difficult to identify the cause of the ailment. Signs and symptoms of a common cold usually appear about one to three days after exposure to a cold virus and may include:

• Runny or stuffy nose
• Itchy or sore throat
• Cough
• Congestion
• Slight body aches or a mild headache
• Sneezing
• Watery eyes
• Low-grade fever (up to 102 F)
• Mild fatigue

Colds can last up to about 2 weeks, and are contagious. During a cold, the discharge from the nose may become thicker and yellow or green in color as a common cold runs its course. It is uncommon to see a high fever with a cold. Nasal allergy symptoms can be distinguished from colds by the fact that they usually last longer, and cannot be spread.

Complications from a common cold:

• Acute Ear Infection ("Otitis Media"). An ear infection occurs when bacteria or viruses enter the space behind the eardrum. This is a frequent complication of common colds in children and occasionally in adults. The signs and symptoms may include hearing loss, earaches, and fever.
• Sinusitis. A common cold that doesn't resolve may lead to sinusitis.
• Other Secondary Infections. These include bacterial throat infections (strep throat), pneumonia, bronchitis, and croup in children.
• Wheezing. A cold can trigger wheezing in patients with asthma.

Treatment:

There is no cure for the common cold. Fortunately, most patients feel better in about a week or two. If the symptoms of a common cold have not improved in that time, bacterial complications should be ruled out and further medical evaluation is necessary to determine the cause of the patient's continued symptoms.

The goals of treatment of the common cold are to make the patient feel better and to help fight off the virus. Since the infection is caused by a virus, antibiotics are ineffective. Although over-the-counter cold medications won't cure a common cold or make it go away any sooner, they often reduce the symptoms. However, most over-the-counter cold medications have side effects and it is wise to read the medication labels carefully. Most heavily advertised over-the-counter cold and flu medications contain multiple drugs to treat many symptoms; therefore their use may result in unnecessary over-treatment. A physician should be consulted before using over-the-counter medication for children under the age of 14.

• Rest and Hydration. The more rest and sleep the better; this allows the body to heal itself faster. Increasing water consumption is very important since a lot of fluid is lost during a cold. Hydration makes the mucus flow more freely and helps with relieving the congestion.
• Nutrition. Good nutrition is essential for resisting and recovering from a cold. It is important to eat a well balanced diet. Consume the recommended dietary allowances for vitamin A, vitamin B complex (vitamins B-1, B-2, B-5, B-6, folic acid) and vitamin C, as well as the minerals zinc and copper. If the diet does not provide an adequate amount of these vitamins and minerals, supplements should be added as needed.
• Pain Relievers. These are effective in reducing fever, sore throat, body aches, and headaches. It is important to read the instructions carefully and to stay within the recommended doses. Aspirin should never be given to children as it has been associated with Reye's syndrome, a rare but potentially fatal illness. Gargling with salt water (1/2 teaspoon of salt in 1 cup of water) is effective in reducing a sore throat.
• Saline Nasal Sprays. Over-the-counter saline nasal sprays help reduce nasal congestion. They are effective, safe and nonirritating. Saline nasal sprays provide moisture to the nasal passages, especially during cold or dry seasons. When the nasal passages are dry, stagnation of mucus and mild nasal crusting may occur. Thus, viruses may not be cleared from the nasal passages in a timely fashion and viral infections can develop under these crusts. Saline sprays clean the nasal passages of crusts and mucus and also help the natural cleaning system of the nasal passages.
• Decongestants. Decongestants fight nasal congestion by temporarily constricting the blood vessels. By reducing the size of the blood vessels, the nasal mucosal swelling, and therefore the nasal congestion, is reduced. Decongestants are available in pill form as well as nasal sprays. Please be aware that over-the-counter nasal decongestant sprays can cause a "rebound effect" when used longer than the recommended period. This results in worsening of the nasal congestion after the medication has been stopped. In addition, decongestant pills may increase blood pressure and heart rate. Decongestants should not be taken without first checking with a physician if the patient has heart disease, high blood pressure, prostate problems, diabetes, or thyroid problems.
• Cough Syrups. Over-the-counter cough suppressants can be helpful if the cough is so severe that it interferes with sleeping or talking. If this is not the case, do not suppress the cough, because coughing removes mucus and germs from your throat and lungs. Coughs associated with a cold usually last less than two to three weeks. If a cough lingers longer than that, you should see your doctor.

Prevention:

There is no effective vaccine for preventing the common cold. However, certain precautions will help slow the spread of cold viruses:

• Hand Washing. Clean hands thoroughly and often. Carry an alcohol-based hand rub, containing at least 60 percent alcohol, for times when soap and water aren't available. These gels are effective at killing most germs.
• Domestic Hygiene. It is important to keep kitchen and bathroom countertops clean, especially when someone in your family has a common cold. You should also wash the children's toys after play.
• Use Tissues. Always sneeze and cough into tissues. Discard used tissues right away, and then wash your hands carefully. If there is no tissue available, you should cough into the bend of your elbow so that your mouth is covered without using your hands. This helps to reduce spread of the common cold by hand contact.
• Don't Share. Don't share drinking glasses or utensils with other family members.
• Steer Clear. Avoid close or prolonged contact with anyone who has a cold.

Sinusitis is an inflammation of the nasal sinuses. Under normal circumstances, the sinuses produce a small amount of mucus. However, when inflammation sets in, the mucosal lining substantially increases mucus production. Inflammation is usually caused by bacterial, fungal, viral or allergic processes.

The inflammation of the nasal sinuses leads to swelling of the sinus mucosa, resulting in blockage of the sinus drainage. Thus, the pus cannot escape into the nose and builds up pressure inside the sinus cavities, causing increased inflammation. This creates a vicious cycle of increasing inflammation and obstruction of the drainage pathways.

Symptoms:

• Pain and tenderness of the involved sinus
• Nasal congestion
• Facial pain
• Headaches
• General malaise and fatigue
• Thick green or yellow nasal discharge
• Post-nasal drip
• Throat irritation secondary to post-nasal drip
• Ear congestion
• Dizziness
• Feeling of facial 'fullness' or 'tightness'
• Aching upper teeth
• Bad breath
• Anosmia (the inability to smell or detect odors)

Complications:

• Chronic Sinusitis. If untreated, sinusitis may develop into a chronic condition.
• Acute Asthma. Sinusitis can trigger an asthma exacerbation.
• Meningitis. The infection can spread to the lining of the brain.
• Vision Problems. Reduced vision or blindness may occur if infection spreads to the eyes.
• Aneurysms or Blood Blots. The infection can cause problems in the veins surrounding the sinuses, interfering with blood supply to the brain.

Diagnosis:

The symptoms of sinusitis can resemble those of colds or allergies. Sinusitis can have severe complications and therefore, it is important to determine if you have sinusitis. There are several methods that Dr. Zadeh at Los Angeles Sinus Institute uses to help screen for sinusitis:

• Nasal Endoscopy. A thin, flexible fiber-optic tube with light and camera at its tip (endoscope) is inserted through the nose, allowing for visual inspection of the sinuses. This is generally a painless procedure which takes a few minutes to complete.
• CT Scan. Images taken using computerized tomography (CT) show details of the sinuses and nasal anatomy. A CT scan is used to define the anatomy, extent of the disease, and response of the treatment course. CT scans also help identify inflammation or physical obstruction that may be difficult to detect using an endoscope.
• Nasal and Sinus Cultures. In general, laboratory tests are not necessary for diagnosing sinusitis. However, when medical therapy fails, tissue cultures may help identify the bacterial pathogen.
• Allergy Testing. If the condition is caused by or exacerbated by allergies, an allergy skin test may be recommended. Allergy testing is a safe and effective method to help diagnose the allergens responsible for the sinus flare-ups.

Prevention:

• Reduce risk of upper respiratory infections. Minimize contact with people who have colds. Wash hands frequently with soap and water, especially before your meals.
• Avoid cigarette smoke. Tobacco smoke can irritate and inflame the nasal passages.
• Use a humidifier. If the air in your home is dry, adding moisture to the air may help prevent sinusitis. Be sure the humidifier is clean and free of mold.
• Limit alcohol consumption. Drinking alcohol can cause sinus passages to swell.

Sinusitis can be classified by location:

• Maxillary Sinusitis - can cause pain or pressure in the cheek and upper teeth area.
• Ethmoid Sinusitis - can cause pain or pressure between and/or behind eyes.
• Frontal Sinusitis - can cause pain or pressure above the eyes and in the forehead.
• Sphenoid Sinusitis - can cause pain or pressure behind the eyes, in the temple, or even the crown of the head.

Sinusitis can also be classified by duration:

• Acute - less than four weeks
• Subacute - four to twelve weeks
• Chronic - more than three months

An acute sinus infection is a sinus infection that lasts two to four weeks and generally responds well to medical therapy. Acute sinusitis is usually precipitated by an earlier upper respiratory tract infection, generally of viral origin. Acute sinusitis may also follow the inflammation associated with an allergy attack or environmental irritants. The inflammation creates swelling which obstructs the sinus openings and prevents mucus from draining normally. This creates a moist environment conducive to infection. Virally damaged sinus tissues are colonized and then infected by virus or bacteria. The virus or bacteria become trapped by swelling in the nose and narrow sinus passages. The trapped virus or bacteria then begin to multiply, causing acute sinusitis. Acute episodes of sinusitis can also result from fungal infections. These fungal infections are most often seen in patients with diabetes or other immune deficiencies.

Clinically, it is difficult to distinguish between bacterial and viral acute sinusitis. However, in general, disease duration of less than 7 days is considered as viral whereas disease duration of more than 7 days is considered as bacterial sinusitis.

Treatment:

Often, acute sinusitis will subside without the need for antibiotics. Self-care techniques as outlined below may speed the recovery process.

The choice of medications is based on the patient's medical condition and disease state.

• Antibiotics. Antibiotics are chosen based on culture results and/or medical judgment.
• Rest and Hydration. The more rest and sleep the better; this allows the body to heal itself faster. Increasing water consumption is very important since a lot of fluid is lost during an infection. Hydration makes the mucus flow more freely and helps with relieving the congestion.
• Nutrition. Good nutrition is essential for resisting and recovering from an infection. It is important to eat a well balanced diet. Consume the recommended dietary allowances for vitamin A, vitamin B complex (vitamins B-1, B-2, B-5, B-6, folic acid) and vitamin C, as well as the minerals zinc and copper. If the diet does not provide an adequate amount of these vitamins and minerals, supplements should be added as needed.
• Pain Relievers. These are effective in reducing sore throat and headaches. It is important to read the instructions carefully and to stay within the recommended doses. Aspirin should never be given to children as it has been associated with Reye's syndrome, a rare but potentially fatal illness. Gargling with salt water (1/2 teaspoon of salt in 1 cup of water) is effective in reducing a sore throat.
• Saline Nasal Sprays. Over-the-counter saline nasal sprays help reduce nasal congestion. They are effective, safe and nonirritating. Saline nasal sprays provide moisture to the nasal passages, especially during cold or dry seasons. When the nasal passages are dry, stagnation of mucus and mild nasal crusting may occur. Bacterial infections can develop under these crusts. Saline sprays clean the nasal passages of crusts and mucus and also help the natural cleaning system of the nasal passages.
• Decongestants. Decongestants fight nasal congestion by temporarily constricting the blood vessels. By reducing the size of the blood vessels, the nasal mucosal swelling, and therefore the nasal and sinus congestion are reduced. Decongestants are available in pill form as well as nasal sprays. Please be aware that over-the-counter nasal decongestant sprays can cause a "rebound effect" when used longer than the recommended period. This results in worsening of the nasal congestion after the medication has been stopped. In addition, decongestant pills may increase blood pressure and heart rate. Decongestants should not be taken without first checking with a physician if the patient has heart disease, high blood pressure, prostate problems, diabetes, or thyroid problems.
• Inhaled Nasal Steroids. Inhaled nasal steroids, or corticosteroids, are inhaled nasal sprays that reduce nasal and sinus symptoms. They do not cause a "rebound effect." They decrease the swelling in the nose and sinuses, thus reducing the congestion and allowing for drainage of the sinuses.

Subacute sinusitis generally lasts 4 to 12 weeks and usually resolves completely after an effective medical regimen. It is the natural progression of acute sinusitis, which may or may not have been treated, that has failed to resolve. In general, the symptoms are less severe than the symptoms of acute sinusitis. Although usually responsive to medical treatment similar to acute sinusitis, surgical options are considered when the symptoms fail to improve or worsen.

In chronic sinusitis, the condition recurs or endures longer than 12 consecutive weeks. Chronic sinusitis is one of the most commonly diagnosed chronic illnesses in the United States, affecting 30 to 40 million Americans each year. Chronic sinusitis begins with an inflammation of the mucous membranes in the sinuses which prevents normal mucus drainage.

Chronic sinusitis can significantly impair one's quality of life. Patients commonly suffer from nasal obstruction, frequent headaches, and tenderness in the face or aching behind the eyes. In addition, there may be chronic yellow or greenish discharge from the nose or drainage down the back of the throat.

Although chronic sinusitis is often caused by infections of the upper respiratory tract (nose, sinuses, and throat) there are also noninfectious triggers. Allergies, smoking, nasal polyps, mold and fungi can also be a factor. Abnormally narrow sinus passages, which can impede drainage from the sinus cavities, can also contribute. Recurrent bouts of sinusitis may result in increased inflammation of the nasal or sinus mucosa and each instance can potentially further narrow the sinus openings.

Treatment:

• Antibiotics. Antibiotics are chosen based on culture results, extent of disease,and/or medical judgment.
• Saline Nasal Sprays. Over-the-counter saline nasal sprays help reduce nasal congestion. They are effective, safe and nonirritating. Saline nasal sprays provide moisture to the nasal passages, especially during cold or dry seasons. When the nasal passages are dry, stagnation of mucus and mild nasal crusting may occur. Bacterial infections can develop under these crusts. Saline sprays clean the nasal passages of crusts and mucus and also help the natural cleaning system of the nasal passages.
• Decongestants. Decongestants fight nasal congestion by temporarily constricting the blood vessels. By reducing the size of the blood vessels, the nasal mucosal swelling, and therefore the nasal and sinus congestion are reduced. Decongestants are available in pill form as well as nasal sprays. Please be aware that over the counter nasal decongestant sprays can cause a "rebound effect" when used longer than the recommended period. This results in worsening of the nasal congestion after the medication has been stopped. In addition, decongestant pills may increase blood pressure and heart rate.
  Decongestants should not be taken without first checking with a physician if the patient has heart disease, high blood pressure, prostate problems, diabetes, or thyroid problems.
  
• Inhaled Nasal Steroids. Inhaled nasal steroids, or corticosteroids, are inhaled nasal sprays that reduce nasal and sinus symptoms. They do not cause a "rebound effect." They decrease the swelling in the nose and sinuses, thus reducing the congestion and allowing for drainage of the sinuses.
• Allergy Shots (Immunotherapy). If allergies are contributing to the chronic sinusitis, desensitization to the allergens may help alleviate the condition. The goal of allergy shots is to "train" the immune system over time to be better able to tolerate the allergens that trigger the symptoms. Allergy testing is used to help identify the specific allergens that are causing the reactions. Allergy shots contain small amounts of these allergens and are given on a regular schedule so that the body gets used to the allergens and no longer overreacts to them.
• Endoscopic Sinus Surgery. In cases that fail to respond to medication, endoscopic sinus surgery may be an option.
• Balloon Sinuplasty. Balloon sinuplasty offers the surgeon an additional tool for sinus surgery. This may be performed by itself or used in conjunction with endoscopic sinus surgery.

Nasal polyps are soft, non-cancerous growths that develop on the lining of the nose or sinuses. They are the end product of chronic inflammation that may result from a viral or bacterial infection, allergies, or an immune system response to fungus. Chronic inflammation causes the blood vessels in the lining of the nose and sinuses to become more permeable, allowing water to accumulate in the cells. Over time, as gravity pulls on these waterlogged tissues, they develop into polyps. Polyps are generally soft and pearl colored, with a consistency like jelly. Polyps may be single or several, clustered together like grapes on a stem.

Symptoms:

It is unusual for small nasal polyps to cause any symptoms. Signs and symptoms of larger nasal polyps include:

• Nasal obstruction
• Runny nose
• Chronic sinus infections
• Loss or diminished sense of smell
• Dull headaches
• Snoring

Treatment:

Treatment of nasal polyps depends on the size of the polyps and symptoms. Medications are the most common treatment for small nasal polyps. Surgery may be needed to remove larger growths, but if the underlying cause of the polyps is not treated, the polyps frequently return. Below are various treatment options for nasal polyps:

• Inhaled Nasal Steroids. Inhaled nasal steroids reduce inflammation and help shrink polyps. This is the preferred treatment for most small polyps.
• Oral Corticosteroids. Oral corticosteroids are faster and more effective in reducing the inflammation and polyps. Unfortunately, the effects are usually temporary. Since oral steroids can cause serious side effects, the treatment course is usually brief.
• Medications to Control Allergies or Infections. In addition to treating polyps, other medications may be necessary to control the underlying cause of the polyps. For example, for polyps caused by allergies, allergy medications in patients with high fever or other allergies may help relieve the allergy symptoms and slow the growth of the polyps, although they won't necessarily eliminate polyps. In addition, antibiotics may be required to treat a sinus infection. If the infection is the underlying cause of the polyps, often times by treating the infection, the polyps resolve.
• Antifungal Medications. On occasion, chronic sinusitis and polyps may be caused by an unusual immune system response to environmental fungus. In these situations, antifungal medications may be useful. In addition, surgical removal of fungal debris also may be necessary.
• Allergy Shots (Immunotherapy). If allergies are contributing to polyp formation, desensitization to the allergens may help alleviate the condition. The goal of allergy shots is to "train" the immune system over time to be better able to tolerate the allergens that trigger the polyps. Allergy testing is used to help identify the specific allergens that are causing the reactions. Allergy shots contain small amounts of these allergens and are given on a regular schedule so that the body gets used to the allergens and no longer overreacts to them.
• Surgery. If medical treatments are not effective, surgical removal of the nasal polyps may be of benefit. Surgical approaches are safe and effective, however, if the underlying cause of the polyps is not also addressed, the polyps are likely to recur.