Nasal polypectomy

Nasal polypectomy is surgery to remove nasal polyps. Nasal polyps are soft, noncancerous growths inside your nose or sinuses. Small polyps may not cause problems, but large polyps can lead to congestion, difficulty breathing, sleep problems, and other symptoms that may affect your quality of life.

Nasal polypectomy is a type of endoscopic sinus surgery, a minimally invasive procedure performed with an endoscope (thin tube with a light and camera). A surgeon uses the endoscope and surgical tools to remove polyps through your nostrils so you won’t have visible incisions (cuts) in your skin.

Nasal polyp removal can offer a variety of benefits, including:

• Better breathing
• Enhanced sense of smell
• Fewer sinus infections
• Improved sleep
• Reduced nasal drainage and sinus pressure

At Penn Medicine, we treat a high volume of nasal and sinus disorders like nasal polyps. Our otorhinolaryngologists (ENTs) have years of experience resolving chronic sinus problems and improving the lives of their patients.

We reserve nasal polyp surgery for people with severe symptoms that haven’t improved with steroid nasal sprays, medication, or other treatments. You may benefit from surgery if you have nasal or sinus polyps related to:

• Aspirin-exacerbated respiratory disease (AERD)
• Asthma
• Chronic sinusitis
• Cystic fibrosis
• Severe allergies

Nasal polypectomy is an outpatient procedure, so you go home the same day as your surgery. An otorhinolaryngologist (a doctor who specializes in ear, nose, and throat conditions) performs the operation. Your care team will give you instructions on preparing for treatment and what to expect during recovery.

Preparing for nasal polypectomy

Before your nasal polyp removal procedure, you may need imaging exams or other tests to evaluate the polyps’ size, shape, and location. A CT scan or MRI produces detailed pictures of your nose and sinuses. These images help your surgeon plan your procedure.

Other recommendations to reduce the risk of surgical complications include:

• Stop smoking at least one month before your procedure
• Don’t take blood thinners, aspirin, or certain supplements for at least 10 days before surgery
• Avoid eating or drinking after midnight on the day of your surgery

During nasal polyp removal surgery

Here’s what to expect during your procedure:

1. You receive general anesthesia, so you’ll be asleep during the procedure and won’t feel any pain.
2. Your surgeon inserts an endoscope into your nostril to view the polyps in your nasal passages or sinuses.
3. With imaging guidance, the surgeon uses special instruments to cut and remove the polyps.
4. The surgeon may remove additional bone or tissue to enlarge your nasal passages and reduce the risk of new polyps forming.
5. Your surgeon removes the endoscope and may put material in your nose to stop bleeding.

After nasal polyp removal surgery, you may have drainage and light bleeding from your nose. You may also notice swelling and mild discomfort, which can make it difficult to breathe through your nose. These side effects are normal and may last for about a week. You should rinse your nose daily with a saline spray to aid the healing process.

We recommend taking it easy for several days. Avoid blowing your nose and keep your mouth open if you sneeze. After a few weeks, you should be able to return to normal activities, including exercise and heavy lifting. Full recovery after nasal polypectomy can take a few months.

All surgeries carry risks. While complications from nasal polyp removal aren’t common, they can include:

• Cerebrospinal fluid leak
• Excessive bleeding
• Infection
• Injury to the skull base or eye sockets
• Vision loss due to optic nerve damage

It’s also important to know that polyps return in about 30 percent of people who have polyp removal surgery. We may recommend intranasal corticosteroids (sprayed or inhaled), antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), or other therapies to reduce the risk of polyps coming back.

Penn Medicine is home to a nationally renowned ear, nose, and throat (ENT) program. Our specialists care for common and complex nose, nasal, and sinus disorders, including nasal polyps and related conditions such as sinusitis and AERD. Our multispecialty approach ensures you receive comprehensive care from otolaryngologists, allergists, pathologists, and other experts as needed.