Nasal polyp treatment in Amman: Doctors and Clinics

Nasal polyps are soft, pale or grey fleshy growths that are painless to touch and arise from chronically inflamed mucosa in the nose and sinuses, hanging down into the airway. They are a manifestation of chronic mucosal inflammation rather than a simple lump that can just be trimmed away, which is why the underlying inflammation is treated alongside removal of the growth itself.

An important clarification prevents a very common confusion: in everyday Arabic the same word is used for two entirely different things. The first is nasal polyps, mostly in adults, which are inflammatory tissue. The second is the adenoid behind the nose in children, normal lymphoid tissue that enlarges and causes snoring, mouth breathing and middle ear fluid. Treatment differs completely between the two, so information about one must not be applied to the other.

Typical symptoms of polyps include persistent nasal obstruction that does not alternate between sides, reduced or absent sense of smell, which is often the patient's most prominent complaint, anterior or posterior nasal discharge, and facial heaviness. Polyps are frequently associated with asthma, aspirin sensitivity and chronic rhinosinusitis, so the patient is assessed as a whole rather than the nose in isolation. Diagnosis rests on nasal endoscopy, completed by CT imaging when surgery is being planned.

Treatment begins medically and continues medically: a regular topical intranasal steroid spray with saline irrigation, a short oral steroid course in selected cases at the clinician's decision, and control of asthma and allergy. Endoscopic surgery is performed for severe obstruction, loss of smell or failure of medical treatment, and modern biologic therapies exist for specific cases and are decided with a specialist. Decongestant drops are not a treatment for polyps; they do not shrink them and they cause rebound congestion.

The limits stated frankly: surgery removes polyps but does not stop the inflammation that produced them, and recurrence is common, particularly if topical treatment is stopped afterwards. Surgery is therefore described as a step that opens the route for medication rather than an endpoint. The sense of smell may improve only partially, or not at all if it has been absent for a long time. Features requiring urgent assessment because they may not be a simple polyp include a growth on one side only, repeated nosebleeds, severe facial pain, cheek numbness, double vision or a protruding eye, and a clear watery leak from the nose. Suitability for any treatment is determined by clinical examination and nasal endoscopy.