Endonasal polypectomy
Endonasal polypectomy is the removal of nasal cavity polyps, the expression of a common disease known as nasosinusal polyposis, which affects between 1% and 4% of the white population and up to 15% of asthmatics. Polyps grow in the sinuses, mainly the ethmoid, and can fill the nasal cavities.
Find out more about endonasal polypectomy from Dr. Delagranda, ENT and cervico-facial surgeon in La Roche sur Yon, France.
Indications and target group for endonasal polypectomy
Who is concerned by endonasal polypectomy?
- Adults with polyps for which medical treatment is no longer sufficient and who do not wish to undergo a more radical operation.
- Children in exceptional cases (cystic fibrosis, Woakes syndrome).
When should an endonasal polypectomy be performed?
Endonasal polypectomy should be performed in cases of disabling nasosinusal polyposis despite well-administered medical treatment: blocked nose that constantly runs down the nostrils and into the throat (nasal obstruction, anterior and posterior rhinorrhea), reduced or absent sense of smell (hyposmia, anosmia), repeated sneezing, sinusitis pain at the top of the skull, forehead, cheekbones, between or behind the eyes.
Endonasal polyps
Endonasal polyps are the expression of nasosinusal polyposis, a chronic inflammatory disease with multi-factorial causes. In the vast majority of cases, there is no precise explanation for nasosinusal polyposis, but it may reflect a more general underlying disease such as cystic fibrosis, primary ciliary dyskinesia, or immune deficiency such as naked lymphocyte syndrome or Wegener’s disease. Diagnosis of naso-sinusal polyposis is clinical, based on the presence of polyps in both nasal cavities. When associated with asthma and/or intolerance to aspirin and non-steroidal anti-inflammatory drugs, this is known as Widal syndrome. Intolerance to the sulfites used in preserves and certain wines, notably champagne, can increase symptoms. If the nose is deformed by the polyps with a “tapir” snout appearance we speak of Woakes syndrome.
Classification of polyps:
- Stage I: polyps localized to the middle meatus.
- Stage II: polyps not exceeding the upper limit of the inferior turbinate.
- Stage III: polyps not exceeding the upper limit of the inferior turbinate.
- Stage IV: polyps reaching the floor of the nasal cavity.
Treatment of nasosinusal polyposis is primarily medical, based on daily saline nose-washing, long-term inhaled corticosteroids and short courses of corticosteroids by mouth.
Objectives of endonasal polypectomy
- Improve the sensation of a blocked nose.
- Reduce anterior and posterior rhinorrhea and their consequences (asthma attacks).
- Reduce sneezing.
- The sense of smell is rarely improved by this simple procedure, as the olfactory zone is not sufficiently cleared.
The different stages of the intervention
Surgical intervention
Under general anaesthetic or local anaesthetic potentiated in the operating theatre, the nasal cavities are cleaned with an anaesthetic, then the polyps are cut and aspirated with a protected suction blade, under visual control via a rigid optic inserted into the nose. A healing foam gel is then placed in both nostrils.
Post-surgery recovery period
In the case of outpatient surgery, the patient usually returns home the same day.
After hospitalization, you should remain at home for 3-7 days, resting and checking for bleeding from the nose or throat.
The surgeon will give you a 3-7 day medical leave if necessary.
Sport is not recommended for the first 15 days, and should be resumed gradually.
Pain is almost non-existent. It is controlled by Class I analgesics.
Post-operative care at home: nosewash with saline, more intense than for polyposis alone, analgesics, inhaled corticosteroids.
Scarring: no visible scar
Complications associated with endonasal polypectomy
In addition to the risks inherent in any surgery involving general or local anesthesia, endonasal polypectomy presents rare complications:
- Nasal haemorrhage (epistaxis) after the procedure: very slight, it rapidly subsides with nose-blowing and nose-washing.
Please refer to the College of ENT’s explanatory sheet on endonasal polypectomy for further explanations and exceptional complications:
Frequently asked questions
Here is a selection of questions frequently asked by Dr Delagranda’s patients during consultations for endonasal polypectomy in La Roche-sur-Yon.
Is the operation compulsory?
No, it’s a comfort operation. The surgeon advises and the patient decides.
Is the effect guaranteed?
Yes, on nasal obstruction and rhinorrhea, but not on olfaction.
Is the effect long-lasting?
This varies from case to case and cannot be predicted. It may last for years, or just a few months, with regrowth of the polyps.
Fees and coverage of the procedure
Endonasal polypectomy is covered by health insurance. Contact your mutual insurance company to find out how much coverage there is for any extra fees.
Do you have a question? Need more information?
Doctor Antoine Delagranda will be happy to answer any questions you may have about endonasal polypectomy. Dr Delagranda is a specialist in ENT surgery at the Clinique st-Charles, La Roche sur Yon, France.
ENT consultation for endonasal polypectomy in Vendée
Dr Antoine Delagranda will be happy to answer any questions you may have about endonasal polypectomy. Dr Delagranda is a specialist in ENT surgery at the Clinique Saint Charles in La Roche-sur-Yon in the Vendée.