Bruce Black is no stranger to sinus trouble. He’s had it for much of his adult life, thanks to hay fever, asthma, and nasal polyps.
Nasal polyps are teardrop-shaped growths that can form anywhere in your nose or sinuses. They aren’t cancer, but can wreak havoc on your nasal passages.
Black’s first surgery to remove nasal polyps was 20 years ago. Since then, the Harrod, OH, man has been on a cycle of sinus infections, polyps, and surgery every few years.
He had his seventh nasal polyp operation in 2021.
“My lower sinuses were fine, but I had polyps growing in my upper sinuses which (doctors) could only pick up with a CAT scan,” he says.
Before his latest operation, Black says, he'd lost his sense of smell. He “just lived with it” for about 2 years, he says.
What Are the Complications of Nasal Polyps?
In addition to affecting your sense of smell, polyps can cause thick mucus and postnasal drip, plus repeated infections if your sinuses are blocked, says Brad deSilva, MD, an otolaryngologist at The Ohio State University Wexner Medical Center in Columbus.
Constant inflammation due to allergies, asthma, or autoimmune conditions contributes to the growth of polyps, says deSilva, who treats Black.
Before considering surgery for nasal polyps, your doctor will try to shrink or eliminate them with other treatments. Along with saline rinses to improve mucus flow and remove irritants, you may use steroid nasal sprays, steroid pills, and/or injections of biologic drugs. The goal of these treatments is to shrink the polyps so you can breathe easier.
When Do You Need Surgery for Nasal Polyps?
But polyps can be difficult to treat. Medicines don't always do the trick.
That's when your doctor may recommend surgery to remove the polyps, if they think you're a good candidate.
First, they'll do imaging scans. This lets them see how many polyps you have and how large they are, and get a look at the bone structure in your sinuses. That creates a roadmap for the surgeon.
Surgery can prevent rare but serious problems that can result from nasal polyps. These include complex sinusitis, which can lead to bone loss and pockets of infection. These abscesses can grow around your eye socket and brain. You even could get meningitis, which is infection of the tissues around the brain and spinal cord.
There’s no cure for nasal polyps. But surgery “has tremendous results for the right patient who is chosen properly," deSilva says.
What to Expect From Nasal Polyp Surgery
You'll most likely get general anesthesia before your operation, deSilva says. Usually, your surgeon removes the polyps using a small tube called an endoscope (basically a small telescope that lets them see inside your nasal passages). The actual surgery may take about 30 minutes or more, depending on the size and location of your polyps.
You’ll probably go home the same day, though you'll need someone to drive you. You should be able to eat your regular diet the day of surgery or the next day.
To lessen bleeding, your doctor will probably ask you to avoid these things in the first few days after your operation:
- Blowing your nose
- Lifting anything heavy
- Bending over so far that your head goes below your waist
Some bleeding from your nose is expected shortly after the operation. But call your doctor if you bleed a lot. They can do a procedure to seal blood vessels in your sinuses to stop blood loss.
Complications from nasal polyp surgery are rare, deSilva says. They include injury to your eyeball or brain, and permanent changes to your sense of smell. Make sure you understand the risks before you choose surgery.
Black describes the surgery as “pretty easy.”
You can expect to return to your normal routine within a week, deSilva says. “I went back to work about 4 or 5 days after surgery,” Black says.
However, it takes about a month to fully heal, deSilva says. Expect to see your doctor several times to remove debris and keep your airways open during this time.
Even when you have successful surgery, nasal polyps tend to grow back. A small but long-term study found that, by 12 years after having nasal polyp surgery, almost 80% of people had gotten polyps again. More than 36% of those people had to have another operation.
To get good results, follow your doctor’s orders and stick to your treatment plan after surgery. This can help you avoid or delay another operation. Your post-surgery treatment plan may include medication.
“We follow our patients closely to make sure they don’t return,” deSilva says.
Black says he uses a nasal saline rinse and a mild steroid nasal spray two times every day. He also gets allergy shots to treat his hay fever.
If he feels a sinus infection coming on, he calls deSilva’s office and is prescribed a round of antibiotics to “knock it out quickly so it doesn’t take hold,” he says.
Your doctor may also prescribe injectable biologic drugs to shrink polyps or prevent them from forming again. Biologics can help you avoid many courses of steroid pills, deSilva says.
Bruce Black’s Words of Wisdom
Black’s advice to others with polyps is to find a sinus doctor you trust. “I had one surgeon who didn’t do a good job at all,” he says.
His sixth surgery was in 2013. He was able to avoid another one for 8 years by sticking with his nasal care routine.
Black admits that he didn’t take good care of his condition after his first few surgeries. “Now, I do the best I can to keep my sinuses clean,” he says.
Still, he doesn’t think his most recent operation will be his last. “Polyps just seems to naturally grow in my sinus cavities,” he says.
But for now, Black says, he feels good. He can even smell and taste his favorite foods again -- something he missed for several years.