Contents
Nasal polypotomy is the removal of polyps from the sinuses and nasal cavity through surgical intervention.
Polyps are benign formations that arise as a result of the destructive effect of inflammatory mediators on the epithelium. As a result, the glandular tissues of the nasopharyngeal mucosa grow, the nasal passages narrow and normal respiratory function is disturbed.
Polyposis can provoke the following diseases: cystic fibrosis, chronic inflammatory processes in the nasal paranasal sinuses; allergic reactions; acquired or congenital anomalies of the nasal cavity. The main method of removing polyps is polypotomy.
Indications and contraindications for the procedure
Polypotomy is prescribed for: difficult nasal breathing; neurological disorders (insomnia, distraction and headaches); frequent attacks of bronchial asthma; regular obstructive bronchitis.
The procedure is contraindicated in the presence of: signs of incipient influenza or SARS infections; high blood pressure; acute infectious diseases; lung and cardiovascular diseases; exacerbations of bronchial asthma and other allergic diseases.
To diagnose polyposis, you need to contact an ENT doctor. The patient’s complaints are taken into account, the nasal cavity is examined using an endoscope. Polyps located near the nostrils can be easily seen and diagnosed. However, if the formation is located deep in the nasal passage, then additional measures will be required to clarify the diagnosis. In this case, CT or MRI is prescribed. These studies allow you to determine the location of polyps, the level of inflammation and their size.
Features and methods of therapy
Treatment of polyps with the use of medicines is effective only in the initial stages. It is important to determine the cause that provoked the development of polyposis. Based on the cause, the doctor may prescribe drug therapy, otherwise it will simply aggravate the condition. Conservative treatment is used in the initial stages, when neoplasms do not greatly interfere with breathing.
After diagnostic procedures, the doctor prescribes medications to avoid polypotomy. For successful treatment, it is undesirable to stop taking medications during the relief imaging period. The drug course should be carried out completely, without interruptions.
Conservative treatment includes the use of drugs:
- anti-inflammatory, antihistamine, antibacterial type of agents;
- nasal corticosteroids;
- cromoglycates.
Steroids prevent the growth of small polyps.
If the cause of polyps is associated with allergic rhinitis, then allergy medications (cetirizine, loratadine, and others) are prescribed. It is also important to avoid contact with the irritant and not cause the development of allergies.
Decongestants are used to reduce swelling and ease nasal breathing. Immunomodulatory therapy helps to improve the function of the immune system. Medications are prescribed strictly by a doctor. The use of drugs is prohibited, since most of them have adverse reactions and contraindications.
In the late stage of polyposis or ineffective drug therapy, an operation is performed to remove polyps. Dexamethasone solution is prescribed for 3 days before surgery to relieve inflammation, swelling and allergic reactions.
A few hours before the start of the operation, a solution of Clemastine is injected. Before the intervention of the doctor, a cleansing enema is made and the patient is immersed in a drug-induced sleep.
There are several types of surgical interventions to remove a polyp from the nose:
- Polypotomy. The easiest way to resect polyps. The intervention is performed under local anesthesia using a Lange hook. Using this tool, the polyp is captured and trimmed. The hook grip is used if the formation is located in the nose grille. There is some bleeding during this operation. The procedure takes an average of one hour. At the end of the operation, the mucous membrane is disinfected and tamponized (tampons with petroleum jelly are inserted into the patient’s nostrils).
- Endoscopic surgery is performed under local anesthesia. An endoscope with a built-in camera is inserted into the patient’s nasal cavity, thanks to which it is possible to examine and assess the size and location of the localization of formations. The image is displayed on the monitor. In this case, the surgeon removes the polyp without damaging the structure of the nose.
- On an outpatient basis, an operation to remove polyps using a laser can be performed. For this, a local analgesic is used. Laser beams are directed to a benign formation. The cells heat up and evaporate. Blood during and after the procedure is usually not visualized. The only drawback of this procedure is the impossibility of resection of formations localized in the sinuses. The use of the laser during pregnancy and with multiple formations on the nasal mucosa is contraindicated.
The process of the operation is chosen by the doctor, taking into account the patient’s condition, the size of the tumors and contraindications.
Recovery after nasal polypotomy and complications
After surgery, the patient is prescribed antibiotics and steroids to avoid potential complications.
Within five days, you need to use drops of oil prescribed by the doctor in the nose for quick healing. Apply them four times a day. Salt spray is used to suppress microbes and allergens from the mucosal surface. To avoid recurrence, it is recommended to use steroid drugs with anti-inflammatory and anti-allergic properties.
If the polyps are not properly handled, there can be dangerous consequences in the nose. The patient may completely lose the sense of smell. This is due to the proliferation of the polyp, blocking the part of the mucous membrane responsible for the sense of smell. In such cases, even surgery will not help restore this function.
As the polyps grow in size, they clog the nasal passages, making it difficult for the lungs to get oxygen. In the future, this will lead to inflammatory diseases of the upper respiratory tract: sinusitis, laryngitis, etc. The most serious consequence that can lead to death is sleep apnea. The patient may stop breathing during sleep due to blockage in the nasal passages. Complications are possible after the operation, but in many cases it is successful.