NASAL POLYP

By Dr Anmol Arora ( Sr Homoeopathic Specialist )

NASAL POLYP

NASAL POLYP

Introduction

Nasal polyps are pearly white, painless, prolapsed, pedunculated parts of the nasal mucosa. Depending on the sinus of origin, they can be ethmoidal or antral. Ethmoidal polyps are chiefly allergic in origin. Nasal polyposis present with nasal obstruction, discharge, headache, sneezing and occasional epistaxis if severely infected.

Nasal polyp ; Defination

Broadly defined, nasal polyps are abnormal lesions that originate from any portion of the nasal mucosa or paranasal sinuses. Polyps are an end result of varying disease processes in the nasal cavities. The most commonly discussed polyps are benign semitransparent nasal lesions  that arise from the mucosa of the nasal cavity or from one or more of the paranasal sinuses, often at the outflow tract of the sinuses.

Multiple polyps can occur in children with chronic sinusitis, allergic rhinitis, cystic fibrosis (CF), or allergic fungal sinusitis (AFS). An individual polyp could be an antral-choanal polyp, a benign massive polyp, or any benign or malignant tumor (eg, encephaloceles, gliomas, hemangiomas, papillomas, juvenile nasopharyngeal angiofibromas, rhabdomyosarcoma, lymphoma, neuroblastoma, sarcoma, chordoma, nasopharyngeal carcinoma, inverting papilloma). Evaluate all children with benign multiple nasal polyposis for CF and asthma.

Aetiology

Many theories have been put forth regarding the aetiology of polyps, all of which may probably contribute to polyp formation:

1. Bernouilli’s Phenomenon

Pressure drop next to a constriction causing suction effect pulling the sinus mucosa into the nose.

2. Polysaccharide changes

Postulated in 1971 by Jackson and Arihood, an alteration in the polysaccharides of the ground substance, as a cause.

3. Infection

Recurrent infection of the sinuses predisposing the mucosa to polypoid changes.

4. Allergy

Allergy has been implicated as a cause, since the nasal secretions contain eosinophils, and patients have signs and symptoms of allergy, often associated with asthma and atopy.

5. Vasomotor theory

Autonomic imbalance has been suggested as a possible cause in non-atopic individuals.

Also implicated are inflammatory mediators, environmental factors, local anatomical factors, Woakes disease and tumours. Genetic predisposition is known to cause polyposis as in cystic fibrosis.

Clinical Features

Nasal polyposis is a disease affecting the adults. When children below 10 are affected, cystic fibrosis needs to be ruled out.

Most patients suffer from nasal obstruction, sneezing, loss of smell and taste, nasal discharge, headache and facial pain, hyponasal voice, postnasal drip and cough. Patients with very severe polyposis may also, present with obstructive sleep apnoea. Asthma and aspirin sensitivity may be present in patients with ethmoidal polyps

Unilateral nasal obstruction may be present in patients with an antrochoanal polyp. Sphenoidal polyposis may present with persistent headaches and infra-orbital neuralgia.

Investigations

Routine haematological testing may show eosinophilia.

Special tests may include a nasal smear for eosinophils in nasal secretions; RAST[radioallergosorbent test];

skin prick test; IgE, IgG levels and sweat tests for cystic fibrosis.

Ciliary dysfunction tests include ciliary beat frequency, electron microscopy of cilia and nasal mucociliary clearance.

Radiological assessment is extremely important in all cases of nasal polyposis. The information obtained through conventional x-rays taken in the Water’s view and the Caldwell’s view is limited. The advent of computed tomographic scanning (CT scan) has revolutionised the understanding of the disease. CT shows the exact site, extent and variation in anatomy offering a road map for the surgeon.

Their extent can be best evaluated by CTscans.

Sinus cat scan showing polyps

Sinus cat scan showing polyps

Sinus cat scan showing polyps (P) within the sinus cavities. This polyp appears to be blocking the sinus outflow tract potentially causing both recurrent infection and pain.

Homoeopathic treatment

Homeopathic treatment for those who suffer from nasal polyps can be a big boon. It can help them save from the surgeon?s knife. Not only does it speedily remove the polyps, it also helps in stopping their recurrences by treating the underlying causes such as allergies asthma or chronic cold.

Homeopathic medicine Sanguinaria is very effective in treating polyps that result out of chronic colds. Homeopathic medicine Teucrium is very effective for large polyps which cause complete loss of smell. Teucrium is also more effective in treating polyps that in the posterior part of the throat. Calcarea Carb, along with the removal of polyps also treats the body?s tendency to develop them over again.

Thuja , Kali bichromicum, lemna minor  are very well proved medicines for polyp nasal.

Polypus bleeding easily on touch , green yellow discharge from nose are guiding symptom for phos ; Chronic nasopharyngeal discharge , Chilliness, Debility –Psor not only cures but also remove the tendency.

Homeopathy is a holistic system of medicine. This means that homeopathy treats the human being as a whole. Detailed mental and physical symptoms of the whole being are taken into consideration while prescribing. This form of homeopathic treatment is called as ?constitutional treatment?. In cases where the polyps are due to deep seated chronic disorders like asthma or allergies this constitutional treatment is usually taken up by homeopathic physicians.

“ HOMOEOPATHY FOR TOTAL SAFE AND NATURAL CURE WITHOUT SIDE EFFECT”

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