Nasal Polypectomy

What is Nasal Polypectomy

Nasal polypectomy is a procedure to remove polyps from the hollow space (nasal cavity) between the nostrils. Polyps are painless, noncancerous growths.

The goal of this procedure is to relieve symptoms caused by nasal polyps, such as nasal congestion, difficulty smelling and breathing, and long-lasting (chronic) sinus infections.

This procedure may be done when methods to shrink polyps are ineffective. During the procedure, polyps are removed through the nostrils. No incisions are necessary for this procedure.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.
  • Current or past smoking habits or tobacco use.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding.
  • Allergic reactions to medicines.
  • Damage to other structures or organs.
  • Blood clot.
  • Return (recurrence) of the polyps.

The following problems may occur, but they are very rare:

  • Loss of the sense of smell.
  • Problems with vision.
  • Cerebrospinal fluid leakage.
  • Brain infection.

What happens before the procedure?

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
  • You may have a physical exam.
  • You may have tests, such as:
  • Imaging tests of the nasal cavity.
    • Nasal endoscopy. In this procedure, a narrow, flexible telescope that has a bright light (endoscope) is used to look into your nasal cavity.
    • Allergy tests.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Do not smoke or use any tobacco products before the procedure for as long as told by your health care provider. This includes cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
  • You may be given antibiotic medicine to help prevent infection.
  • You may be given a medicine to help reduce swelling (steroid).
  • Plan to have someone take you home after the procedure.
  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

  • You will be given one or more of the following:
    • A nasal decongestant spray.
    • A steroid medicine to help reduce nasal congestion, nausea, and vomiting that you might experience after the procedure.
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • Your surgeon may insert a flexible tube with a camera on the end of it into one of your nostrils. This lets your surgeon view your nasal cavity more clearly.
  • If your polyps are small or toward the front of your nasal cavity, your surgeon may cut the polyps away from your nasal cavity.
  • If your polyps are large or deep inside of your nasal cavity, your surgeon may insert a thin tube into your nostril. The tube has a surgical instrument attached to the end of it, which your surgeon may use to cut or suction the polyps away from your nasal cavity. The polyps will be removed starting at the back of your nasal cavity and moving toward the front.
  • Ointment and bandages (dressings) may be applied to your nasal cavity.
  • Gauze may be placed inside of your nasal cavity.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • You may have gauze in your nasal cavity.
  • Your nose will feel congested.
  • You may have some pain. Medicines will be available to help you.
  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
  • Do not drive for 24 hours if you received a sedative.

Nasal Polypectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to have:

  • Pain and congestion in your nose.
  • Some bleeding from your nose.

Follow these instructions at home:

Medicines

  • Take and use over-the-counter and prescription medicines only as told by your health care provider. This includes nasal sprays.
  • Do not drive or operate heavy machinery while taking prescription pain medicine.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Wound care

  • Follow instructions from your health care provider about how to change your bandages (dressings). Make sure you wash your hands with soap and water before and after you change your dressings. If soap and water are not available, use hand sanitizer.
  • Wash out (irrigate) your nasal cavity as directed. You may be directed to irrigate your nostrils with a saline nasal spray.
  • Check your nose every day for signs of infection. Check for:
    • Redness, swelling, or more pain.
    • More fluid or blood.
    • Unusual warmth.
    • Pus or a bad smell.

Activity

  • Rest and return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Avoid contact sports for 3–6 weeks or for as long as told by your health care provider.
  • Do not bend over until your health care provider says this is safe.
  • Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider says this is safe.

Lifestyle

  • Do not smoke or use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
  • Do not drink alcohol for as long as told by your health care provider.

General instructions

  • If directed, put ice on your nose and surrounding area:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Avoid the following things for as long as told by your health care provider:
    • Things that irritate your nose, such as secondhand smoke, allergens, or dust.
    • Blowing your nose.
    • Taking hot baths.
    • Drinking hot beverages.
  • Wash your hands often with soap and water. If soap and water are not available, use hand sanitizer.
  • Use a humidifier at home to help prevent nasal dryness.
  • Irrigate your nasal cavity regularly with a saline spray or solution.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your ability to breathe through your nose does not improve.
  • You have difficulty sleeping.
  • You have more blood or fluid coming from your nose.
  • You develop redness, swelling, or more pain in your nose.
  • Your nose feels unusually warm.
  • You have pus or a bad smell coming from your nose.
  • You develop new symptoms.

Get help right away if:

  • You develop a fever.
  • Your nose drips fluid all the time and you always feel like you need to swallow.
  • You have vision problems or eye pain.
  • You have a headache that does not go away.
  • You have severe neck pain.
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