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Nasal Polypotomy

Nasal polypotomy is the removal of polyps from the sinuses and nasal cavity through surgery.

Polyps - formations of benign type, which arise due to the destructive effect of inflammatory mediators on the epithelium. As a result, the glandular tissues of the nasopharyngeal mucosa expand, the nasal passages narrow and the normal respiratory function is disturbed.

Polyposis can trigger 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, confusion and headaches); frequent bouts of bronchial asthma; regular obstructive bronchitis.

The procedure is contraindicated in the presence of: signs of incipient flu or ARVI infections; high blood pressure; acute infectious diseases; pulmonary and cardiovascular diseases; exacerbations of asthma and other diseases of the allergic type.

To diagnose polyposis, it is necessary to contact an ENT specialist. Patient complaints are taken into account, the nasal cavity is examined using an endoscope. Polyps localized 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, a CT scan or MRI is prescribed. These studies can 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 tumors do not greatly interfere with breathing.

After diagnostic procedures, the doctor prescribes medication to avoid polypotomy. For successful treatment, it is undesirable to stop taking medication during the period of visualization of relief. The drug course should be completely, without interruption.

Conservative treatment includes the use of drugs:

  • anti-inflammatory, antihistamine, antibacterial type of agents;
  • nasal corticosteroids;
  • cromoglycate.

Steroids inhibit the growth of small polyps.

If the cause of polyps is associated with allergic rhinitis, then allergy medications are prescribed (cetirizine, loratadine, and others). It is also important to avoid contact with the irritant and not to cause the development of allergies.

Decongestants are used to reduce puffiness and facilitate nasal breathing. Immunomodulatory therapy helps to improve the function of the immune system. Medications are prescribed strictly by the doctor. The use of drugs is prohibited, since most of them have adverse reactions and contraindications.

At the late stage of polyposis or ineffective drug therapy, surgery is performed to remove the polyps. Before surgery, a solution of Dexamethasone is prescribed for 3 days to relieve inflammation, edema and allergic reactions.

A few hours before the operation, Clemastine solution is injected. Before the intervention, the doctor makes a cleansing enema and immerses the patient in a drug sleep.

There are several types of surgery to remove a polyp from the nose:

  1. Polypotomy. The easiest way to resect polyps. The intervention is performed under local anesthesia with a Lange hook. Using this tool, the polyp is captured and trimmed. A hook grab is used if the formation is located in the nose grating. At this operation, there is a slight bleeding. The procedure lasts an average of an hour. At the end of the operation, the mucous membrane is disinfected and tamponised (tampons with vaseline are inserted into the patient's nostrils).
  2. Endoscopic surgery is performed under local anesthesia. An endoscope with an integrated camera is inserted into the nasal cavity, so that the size and location of the formations can be examined and assessed. The image is displayed on the monitor. In this case, the surgeon removes the polyp without damaging the structure of the nose.
  3. On an outpatient basis, an operation can be performed to remove the polyps using a laser. For this, a local-type analgesic is used. Laser beams are sent to a benign education. 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 the lesions localized in the sinuses. Using a laser during pregnancy and with multiple formations on the nasal mucosa is contraindicated.

The process of operation is chosen by the doctor taking into account the patient’s condition, the size of the tumors and contraindications.

Restoration after polypotomy of the nose and complications

After surgery, antibiotics and steroids are prescribed to the patient to avoid potential complications.

Within five days you need to use the prescribed doctor drops of oil in the nose for quick healing. Apply them four times a day. To suppress microbes and allergens from the mucosal surface, a salt spray is used. To avoid recurrence, it is recommended to use steroid drugs that have anti-inflammatory and anti-allergic properties.

If polyps are improperly handled, there may be dangerous effects in the nose. The patient may completely lose the sense of smell. This is due to the proliferation of the polyp, which blocks 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 size increases, the polyps block the nasal passages, making it difficult to access oxygen in the lungs. 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 of the nasal passages. After surgery, complications are possible, but in many cases it is successful.

Watch the video: Nasal Cleansing - Mayo Clinic (April 2020).

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