At the beginning of the formation of polyps do not cause discomfort and remain undetected for as long as their size It will not be significant and they begin to irritate and damage the normal nasal breathing and the sense of smell. According to doctors, the most effective way of getting rid of the polyps is their removal. However, if education does not reach large sizes, you can try to deal with it on their own, without resorting to surgery.
The reasons for which there are polyps in the nose, is not yet known. With high probability we can say that the development of the disease run multiple causal factors simultaneously.
The main mechanism of formation of polyps is to increase the quantity of the secretory glands. The experiments proved that in case of damage of the upper layer of the mucosa (epithelium), it ruptures, edema and infiltration of the middle layer falls mucous or mucous itself. As a result, it protrudes through an opening in the epithelium. And if the epithelium is not fully restored, then the proper mucosal polyp formed and it has grow glands that produce mucus.
The main risk factors for why a person in the nasal passages can be formed polyps include:
- allergic rhinitis. Tragically, with allergist every year put more diagnoses "allergy". It is caused by poor environmental conditions, poor nutrition, maintenance of life. Most often, there is an allergic reaction to dust, both domestic and street, to pollen especially in spring and summer, to animal dander, to some certain chemical substances. If an allergic reaction is temporary and one-time in nature (eg, a person pochihal), the special risk of polyps is not. But if the stimulus is present in the air constantly, the mucous membrane over time grows and thickens due to the constant swelling
- The inflammation of the paranasal sinuses, such as sinusitis. During this disease the person not only feels unwell, but also begins to twang. Namely, this twang shows severe swelling of the mucous membrane, that is, that the process of destruction of cells occurs and the infiltration of bacteria.
- Colds, runny nose during that appears. And it is not a cold once a year, and on a permanent morbid condition.
- Penetration into the body of pathogenic bacteria and microbes which cause rhinitis various etiologies.
- A deviated septum, which may be either congenital or acquired. In most cases, the nasal septum is curved as a result of injury to the nose, especially in fractures. If the nasal passages are curved, the air therein is not received as required by the organism. And because of this connective tissue gradually expands, and begin to form polyps.
- The reaction of the immune system. The immune system of each person working originally. In some reaction to a stimulus and a provocateur, and the other quite the opposite. So, for some people the nasal mucosa in contact with viruses and bacteria begins to thicken, just once, thus helping the formation of polyps.
- Heredity. Many doctors say that a predisposition to the formation of polyps in the nose is common. This does not mean that they must necessarily appear. Just under the influence of negative factors of the process will be much faster. And if a person not having a genetic predisposition to sprouting polyps can do everything, then here at the one whose parents (grandparents) have suffered from the problem, will definitely be following her owner.
Mucous to continuously perform its functions, at some point, just beginning to grow, that is, try to perform all by increasing the area. And as a result of an intensive growth able to provoke polyps. Especially if the stimulus is present in the air constantly.
Stage of development and types
On the basis of place of occurrence, polyposis can be:
- Antrohoanalny arising from the maxillary sinuses. More common in children and is located on one side.
- Ethmoidal, emerging from the ethmoid mucosa. It affects both sides of the nasal septum to the lattice fabrics mainly adults.
- Very common choanal polyp growing from maxillary "pockets" as antrohoanalny. Choanal developing type of retention cysts.
Nasal polyps, given their size and they have provoked changes are divided into three stages:
- First. Polyps appear, filling only a small part of the nasal space and without causing too much discomfort.
- Second. Tumors grow rapidly, expanding, closing a significant portion of the nasal cavity, making it difficult for a person's breath.
- Third. Education is fully cover the course of breathing, and the person breathes bad nose, lost sense of smell. As a result, organs and cells receive less oxygen, because it enters through the mouth is not enough.
Growths in the nose usually do not bother the patient - they did not itch, does not hurt, do not bleed. Symptoms of disease depend on which of the above stage of development observed in humans.
Signs and photos
Most often the disease occurs as a chronic runny nose, while you may notice a few extra features.
Nasal polyps have these symptoms:
- Violation of smell, sometimes it disappears entirely;
- sinusitis (antritis, Etmoidit);
- In humans, there are bouts of the common cold with sneezing, snot flowing from the nose mucous, muco-purulent. Basically, runny nose appears on the dust, pollen and other allergens;
- Nasal congestion. The degree of congestion is dependent on the amount and degree of proliferation polyps. They grow rapidly and can completely block the nasal passages, causing their complete obstruction;
- Headaches of varying intensity, are due to the development of septic complications polyposis, insufficient oxygen supply to the brain;
- Facial pain or a feeling of compression, which is enhanced by a cold.
- People complain of poor general condition, insomnia, heaviness in the head, mental decline and memory abilities;
- If polyps have begun to grow in the nasopharynx, the discharge could flow down the back of the throat.
If polyps are irregular in shape, hurt and bleed, an urgent need to seek medical help, it can be a malignant tumor.
The more dangerous polyps in the nose?
The danger of proliferation of the nasal mucosa in the first place is the development of complications. When natural breathing nose does not hampered it occurs humidifying and warming entering the lungs. Furthermore, it is removed from the dust particles which remain on the mucosa, and then the naturally derived. Polyps do not allow air to pass through the nasal passages, forcing the human mouth breathing.
As a result, air does not have time to properly warm up that provokes diseases such as:
As a result of the fact that there is a violation of natural communication between the nasal sinuses, the patient suffers from chronic sinusitis.
The more sprawl, the more it puts pressure on the blood vessels of nasopharyngeal tissues, causing inflammation of the tonsils and the formation of adenoids, An increase of tonsils with symptoms of angina. Also, poor circulation can lead to the development of chronic tonsillitis Clinic. As for violations of the auditory tube, the increased pressure on it leads to the development of otitis or evstahiita.
How to treat?
Basic medication drugs that are used to get rid of polypoid sinusitis:
- Antibiotics (ceftriaxone). Appoint, if nasal polyps were the result of inflammation of the sinuses.
- Allergy means (loratadine). Often polyps are the result of allergies, so you need to identify the causative agent, to avoid contact with them and at the same time take Allergy medicines.
- Topical steroids (mometasone, fluticasone) in high doses. Significantly reduce the size of polyps in the nose, but only assigned when severe cases, because they have a lot of adverse reactions.
- Immunotherapy (Ribomunil). Apply if the polyps are caused by decreased immunity, drugs contribute to the emergence of new antibodies.
- Mast cell stabilizers membranes (sodium cromoglycate, ketotifen). Inhibit the release of histamine, provoking active airway mucosal edema nasal allergy.
- Exception products containing salicylates and certain food dyes, cancellation of NSAIDs. Such a method of treatment the doctor prescribes are hypersensitive to aspirin.
If a patient has a serious stage of development of polypoid sinusitis or medication did not have the desired effect, it is necessary to resort to an operable activities. There are four species removal of polyps, which differ in the length and overall recovery period trauma to the nasal cavity. On them will be discussed in detail below.
You can not make surgical removal of polyps from the nose:
- in exacerbation of bronchial asthma, obstructive bronchitis, allergic rhinitis;
- during the period of seasonal hay fever in people who are allergic to pollen;
- heart failure, coronary artery disease;
- acute infectious diseases;
- in case of serious diseases of internal organs.
Undesirable operation also at cold, even minor malaise, elevated blood pressure - all of which can affect both the course of the surgery, as well as on the course of the recovery period.
The procedure is performed under local anesthesia. Through a nostril administered to the nasal cavity with the endoscope camera. The image is displayed on the computer screen. This makes it possible to accurately determine the size and number of polyps and remove them without touching the important structures of the nose. With the help of endoscopic equipment remove all affected tissue and perform correction of the nose structure. With this method of treatment is not traumatic scars and scars.
After surgery, there is a feeling of discomfort, which is quite fast. The patient feels significant relief breath. For 2-3 days may sukrovichnye or mucous (not pus) discharge. Within a day the patient is discharged home, and after 3 days he can go to work. In the postoperative period prescribed Pinosol oil drops 3 times a day for 5 days. Then spray "Nasonex".
Polipotomiya - an operation which can get rid of polyps via cutting the loop or hook Lange. It is considered an advantage that a single procedure can get rid of many polyps.
On the day of surgery should refrain from eating. The procedure is performed under local anesthesia. In the region of the polyp administered 2 ml of 1% novocaine solution. Introduced through a nostril loop and capture the polyp it. Gradually narrow the lumen of the loop around the polyp stem and cut it. Lange Hook is used when you want to remove a polyp arising from trellised labyrinth. The treatment lasts from 45 minutes to an hour.
During the operation, the patient sits in a chair and holding a reniform basin. His head was covered with a sterile sheet. After the surgery mucosal surface disinfected. If necessary, the nose tamponiruyut. In the nose insert impregnated with petroleum jelly and fix them turundy sling bandage. After this procedure is left scars and bleeding is usually very small.
After surgery, the patient is still a few days left in the hospital. Tampons are removed the next day and smeared ointment sintomitsinovoy. Prescribed by a doctor the patient goes to the nasal lavage. After 5-7 days, the doctor prescribes the patient's home. Full recovery period takes 10 to 20 days.
Removal of polyps laser
This procedure can be performed on an outpatient basis, that is to go to the hospital is not necessary. On this day there is no better. The patient is administered to the polyp analgesic drug. The nasal cavity is introduced endoscope with a camera and laser equipment. With the help of a laser beam heats the doctor cells that make up the polyp, and they evaporate. During operation the laser solders vessels, and bleeding does not occur. Also in this procedure, the possibility of infection is completely eliminated. This is the least traumatic procedure, it is suitable for people with asthma and children.
After surgery, the patient has to come a few days to see a doctor to monitor the state of the mucous membrane. It is not recommended to drink alcohol, attend bath and exercise. This may cause bleeding. special sprays are often prescribed for the prevention of re-occurrence of polyps.
One type of endoscopic surgery when the doctor sees everything that happens on the screen and in full control of the situation. The procedure is performed under general or local anesthesia.
Shaver or mikrodebrider as accurately removes polyps to healthy tissue. He seems to be a neoplasm grinds and sucks them. The operation is low-impact and allows you to preserve a healthy mucosa. The risk of bleeding is minimal. If necessary, the doctor can fix any anatomical defects of the nose and remove polyps in the sinuses. This is the only method, after which almost never repeated polyps.
After surgery, the patient remains in the hospital for 3-5 days. In this period are assigned washing with brine to remove tissue residues, antibiotics for preventing secondary infections. Topical steroids prescribed drugs for the prevention of re-proliferation of connective tissue.
There are primary and secondary prevention of nasal polyposis:
- Primary prevention is the responsibility of a healthy lifestyle, adequate and timely treatment of pathologies of upper respiratory tract, especially the nasal cavity diseases.
- Secondary prevention treatment is reduced to the underlying disease (e.g., asthma).
Of course, polyps in the nose - this unpleasant disease, besides significantly impairs quality of life, but it is treatable. The main task - to take care of their health, well-being and to listen to at the first sign of trouble consult a doctor.