Nasal Polyp

1. Firstly, Bilateral ethmoidal polypi

2. Secondly, Antrochoanal polyp [1]

Cause

The exact cause of nasal polyps is unclear. In detail, They are, however, commonly associated with conditions that cause long term inflammation of the sinuses. This includes chronic rhinosinusitis, asthma, aspirin sensitivity, also cystic fibrosis.

Various additional diseases associated with polyp formation i.e.:

• Allergic fungal sinusitis
• Kartagener’s syndrome
• Young’s syndrome
• Eosinophilic granulomatosis with polyangiitis
• Nasal mastocytosis

Chronic rhinosinusitis is a common medical condition characterized by symptoms of sinus inflammation lasting at least 12 weeks. The cause is unknown and the role of microorganisms remains unclear. It can be classified as either with or without nasal polyposis.[1][2]

Cystic fibrosis (CF) is the most common cause of nasal polyps in children. Therefore, any child under 12 to 20 years old with nasal polyps should test for CF. Half of people with CF will experience extensive polyps leading to nasal obstruction and requiring aggressive management.

Nasal mucosa, particularly in the region of middle meatus and turbinate, becomes oedematous due to collection of extracellular fluid causing polypoidal change. Polypi which are sessile in the beginning become pedunculate due to gravity and excessive sneezing.

In early stages, surface of nasal polypi cover by ciliated columnar epithelium like that of normal nasal mucosa but later it undergoes a metaplastic change to transitional and squamous type on exposure to atmospheric irritation. Submucosa shows large intercellular spaces filled with serous fluid. There is also infiltration with eosinophils and round cells.[2]

• Nasal congestion
• Sinusitis
• Loss of smell
• Thick nasal discharge
• Facial pressure
• Nasal speech
• Mouth breathing [1]

Diagnosis can be easily made on

1. Clinical examination

Generally, Examination of the nose with an endoscope may reveal a either choanal or antrochoanal polyp hidden posteriorly in the nasal cavity.

Posterior rhinoscopy may reveal a globular mass filling the choana or the nasopharynx. Additionally, A large polyp may hang down behind the soft palate also present in the oropharynx

2. Computed tomography (CT) scan

In brief, CT scan of paranasal sinuses is essential to exclude the bony erosion and expansion suggestive of neoplasia.

3. Histological Examination

Simple nasal polypi may sometimes associate with malignancy underneath, especially in people above 40 years and this must exclude by histological examination of the suspected tissue. In detail, CT scan also helps to plan surgery.

4. X-rays

of paranasal sinuses may show opacity of the involved antrum. X-ray (lateral view), soft tissue nasopharynx, reveals a globular swelling in the postnasal space. It is differentiated from angiofibroma by the presence of a column of air behind the polyp.[2]

CONSERVATIVE

1. Firstly, Early polypoidal changes with oedematous mucosa may revert to normal with anti histaminics and control of allergy.
2. Secondly, A short course of steroids may prove useful in case of people who cannot tolerate anti-histaminic and/or in those with asthma and polypoidal nasal mucosa. They may also use to prevent recurrence after surgery. Contraindications to use of steroids, e.g., Hypertension, peptic ulcer, diabetes, pregnancy and tuberculosis should be excluded.

SURGICAL

1. Polypectomy
2. Intranasal ethmoidectomy.
3. Extra-nasal ethmoidectomy.
4. Trans-antral ethmoidectomy
5. Endoscopic sinus surgery.[2]

Homeopathy can treat nasal polyps. Nasal polyps are considered a case for surgery under the conventional mode of medicine. However, Homeopathy offers an alternative by treating nasal polyps internally, without invasive procedures. Homeopathy treats the symptoms of nasal polyps as well as help shrink the nasal polyps. These medicines, which are both natural and safe, attack the disease at the root and set off the body’s own restorative processes for complete treatment. Some top-rated medicines for treating nasal polyps are Teucrium Marum, Lemna Minor, Sanguinaria Nitricum, Allium Cepa, Kali Bichromicum, and Calcarea Carb.[4]

Lemna Minor – Top Remedy for Nasal Polyps

Basically, Lemna Minor is one of the top-grade medicines for nasal polyps. It works well where there is obstruction of nose and loss of smell from nasal polyps. Additionally, A putrid smell in the nose may also felt in some cases. Thick, yellow-white discharge from the nose is another attending feature. In some cases, mucopurulent nasal discharge observe. In cases where nasal polyps worsen in wet weather too, Lemna Minor is the medicine to prescribe. It also treats swollen nasal turbinates very well.

Teucrium Marum – For Polyps with Nasal Blockage

Teucrium Marum is a most wonderful medicine for nasal polyps with marked nasal blockage. A unique symptom is obstruction of the side of the nose on which the person lies down. Loss of smell is also noted. Crawling sensation in the nose may arise. Teucrium Marum is also one of the best medicines for ozaena. Ozaena is chronic inflammation of the nasal mucosa resulting in its atrophy.[4]

Sanguinaria Nitricum and Kali Nitricum – For Right-sided Polyps

Sanguinaria Nitricum and Kali Nitricum are excellent medicines for right-sided nasal polyps. A person who needs a prescription of Sanguinaria Nitricum shows watery, nasal discharge or burning nature. Other features are pressure over the root of the nose, plugged sensation in nostrils, enlarged nasal turbinates, sneezing and yellow, bloody mucus discharge from the nose. The symptoms guiding the use of Kali Nitricum in addition to right-sided nasal polyps are coryza with nasal obstruction, sneezing, loss of smell and digging pain in nostrils.[4]

Calcarea Carb – For Left-sided Nasal Polyps

Calcarea Carb is an extremely suitable medicine for left-sided nasal polyps. This prescription is given to persons who complain of a blocked nose on the left side. Other attending features are fetid smell and yellow discharge from the nose. In the morning, dryness in the nose may be felt. Sneezing, markedly in the morning time, may also attend. Persons given Calcarea Carb tend to catch a cold easily, with the slightest change in weather.[4]

Allium Cepa – For Constant Sneezing in Nasal Polyps

In the case of nasal polyps with constant sneezing, Allium Cepa offers the perfect treatment. An attending feature is the watery discharge of burning, acrid nature from the nose. The nasal discharge corrodes the upper lips. Headache may also persist along with fluent coryza. Some feel there’s a lump at the root of the nose. Nose stoppage may also be observed.

Kali Bichromicum – For Post Nasal Discharge in Nasal Polyps Cases

For postnasal discharge in nasal polyps’ cases, Kali Bichromicum is selected. The post nasal discharge is thick, lumpy, ropy in nature. It is attended with much hawking. Marked pressure at the root of the nose is complained of. A fetid smell from the nose is another concern. Violent sneezing in the morning time may accompany the above features. Kali Bichromicum is also a prominent medicine for treating nasal polyps from chronic sinusitis.

Phosphorus – For Bleeding Nasal Polyps

Phosphorus is a very effective medicine for nasal polyps that bleed easily. Apart from the bleeding, the condition is accompanied by coryza with dull headache and sneezing which worsens with strong odors. Blocked nose early in the morning is a sure sign that Phosphorus will work. Also, in cases where coryza and dryness of the nose alternate, Phosphorus is the best medicine.[4]

• Hygiene: Maintain good hygiene of the self as well as the environment so that infection can be minimized.
• Treatment of Existing Conditions: Take timely and appropriate medicines to treat Common Cold, Bronchitis, Asthma, or any other respiratory ailment you may be having.[3]
• Restrict Allergen Exposure: Avoid exposure to allergens like pollen, perfumes, smoke, tobacco, dust, chemical fumes which cause inflammation and irritation of the nasal passage.
• Steam: Take steam inhalation if there is a persistent cold.
• Yoga: Deep breathing exercises like Pranayama help to ease breathing and prevent infections.[3]

Frequently Asked Questions

What is Nasal Polyp?

Nasal polyps (NP) are noncancerous growths within the nose or sinuses.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Nasal Polyp?

• Lemna Minor
• Teucrium Marum
• Sanguinaria
• Calcarea Carb
• Allium Cepa
• Kali Bichromicum
• Phosphorus

What causes Nasal Polyp?

• Rhinosinusitis
• Asthma
• Aspirin sensitivity
• Cystic fibrosis
• Allergic fungal sinusitis
• Kartagener’s syndrome
• Young’s syndrome
• Eosinophilic granulomatosis with polyangiitis
• Nasal mastocytosis

What are the symptoms of Nasal Polyp?

• Nasal congestion
• Sinusitis
• Loss of smell
• Thick nasal discharge
• Facial pressure
• Nasal speech
• Mouth breathing