ENT surgeon here: a nose that’s always blocked and a sense of smell that’s gone often means nasal polyps. What they are and how they’re treated

 


After viral infections, sinus disease is one of the most common reasons people lose their sense of smell for months at a time. In my practice in Delhi, I regularly see people who have lived with nasal polyps for years, thinking they just have a permanent cold or “sinus”.

What polyps are

Nasal polyps are soft, painless swellings of the lining of the nose and sinuses, a bit like peeled grapes. They grow out of long-standing inflammation, usually on both sides, and they are not cancer. Doctors call the condition chronic sinusitis with nasal polyps.

Signs that point to polyps

The nose stays blocked on both sides for months. Smell fades or goes, and food loses its taste with it. There’s often a runny nose or mucus running down the throat, a feeling of fullness in the face, and snoring or mouth breathing at night.

Many people with polyps also have asthma. Some get wheezy or more blocked after aspirin or painkillers like ibuprofen, a combination called aspirin-exacerbated respiratory disease. If that sounds like you, tell your doctor, because it changes the treatment plan.

A North Indian twist

Fungus in the air can play a part here. A study of villages in Punjab and Haryana found fungal sinusitis in more than a quarter of people with chronic sinusitis, mostly an allergic type, and fungal spores in the air peaked in winter in wheat-threshing areas. This allergic fungal sinusitis often causes polyps too. It needs to be recognised, because it tends to come back if it’s only partly treated.

How they’re found

A nasal endoscopy, a thin camera passed into the nose in the clinic, usually shows polyps within a few minutes. A CT scan is done when surgery is being planned, or to see how far the disease extends.

How they’re treated

Medicines come first. A steroid nasal spray used every day, with the right technique, shrinks polyps and is the backbone of treatment, often along with saline rinses. A short course of steroid tablets can shrink polyps quickly during a bad spell. Repeated courses carry side effects, so they’re used sparingly.

When medicines don’t give enough control, endoscopic sinus surgery removes the polyps and opens up the sinuses through the nostrils, with no cut on the face. Most people breathe and smell better afterwards, but polyps can grow back. In one large study, about 4 in 10 patients had some regrowth within 18 months, which is why the steroid spray continues after surgery.

For severe polyps that keep returning, especially in people with asthma, there are now biologic injections such as dupilumab. In large trials it shrank polyps and improved both breathing and smell.

Will my smell come back?

Often it comes back at least partly once the polyps and swelling are under control. The longer smell has been gone, the less predictable the recovery.

Get checked sooner if

Get a prompt check if the swelling is on one side only, your nose bleeds, a child has polyps, or you notice swelling around the eye or double vision. These can point to something other than ordinary polyps.

Happy to answer general questions in the comments. I can’t diagnose anyone over Reddit, so please see a doctor in person about your own symptoms.

Sinus Surgery Treatment in Delhi

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