From nasal congestion to loss of taste and smell, nasal polyps can resemble many other sinus conditions. Here’s how to tell the difference.
You may develop nasal polyps when your nasal passages or sinuses are constantly irritated and swollen. These soft, noncancerous growths can be found in nasal passages and sinuses and form from the thin, soft tissue (mucous membranes) that line these areas.
Because nasal polyps are small and lack sensation, you may not realize you have them. Although nasal polyps can cause certain symptoms, not everyone has symptoms. What’s more, nasal polyps share symptoms with other conditions affecting the nose and sinuses, making it tricky to tell if you have them.
“Nasal polyps often manifest with changes in sense of smell, nasal obstruction, congestion, and mucus either being blown out of the nose or being felt as postnasal drip,” says Alexander Schneider, MD, an otolaryngologist at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois. (Postnasal drip is the flow of mucus from the back of the nose down into the throat.)
Nasal polyps often develop in people with chronic rhinosinusitis, a medical condition involving inflammation of the nose and sinus cavities that’s reported to affect almost 12 percent of the adult population. People with asthma, allergies, repeat infections, or nasal inflammation are also more likely to get polyps.
So, how can you tell if it’s nasal polyps or something else? Read on to narrow it down. Note that symptoms may vary from person to person, so always check with your doctor to get a proper diagnosis.
Small nasal polyps may not cause any symptoms. But larger polyps can lead to:
Headache
Loss of smell or taste
Nasal congestion or runny nose
Nosebleeds
Postnasal drip
Pain or pressure in the sinuses
Snoring
Cough
Frequent asthma attacks in people who have asthma
Repeat sinus infections in people with sinusitis
Sleep disorders such as sleep apnea
Breathing problems
Because nasal polyps cause many of the same symptoms as other sinus conditions, it can be tough to know what you’re experiencing. Polyps can be confused with acute rhinosinusitis, allergic rhinitis, and nonallergic rhinitis.
Sometimes, polyps can appear on only one side. When this happens, the growth may be a tumor or another one-sided condition, such as a sinus mucocele, says Chester F. Griffiths, MD, the director of the eye, ear, and skull base center and head and neck surgery and endoscopic skull base surgery at Pacific Neuroscience Institute in Santa Monica, California.
Acute rhinosinusitis involves sinus inflammation that’s caused by an infection, most commonly viruses like rhinoviruses, which is responsible for the common cold. Like nasal polyps, signs and symptoms of acute rhinosinusitis often include:
Congestion
Sinus pain and tenderness
Headache
Changes in smell
But you may also experience fatigue and fever with acute rhinosinusitis. Plus, most cases of acute rhinosinusitis resolve on their own within a week to 10 days. But sometimes, you may develop a bacterial infection that leads to chronic rhinosinusitis.
Like the acute version, chronic rhinosinusitis is characterized by inflammation of the nose and sinus cavities. The condition is considered chronic when the symptoms associated with acute rhinosinusitis — with the exception of fever — have gone on for more than 12 weeks, despite medical treatment.
Chronic rhinosinusitis occurs after an irritation (infection, allergies, or trauma, for example) causes blockage of the sinus opening, leading to remodeling of the sinus lining with more mucus and inflammatory cells. People with allergic rhinitis (more on this next) and asthma are more likely to have chronic rhinosinusitis, but it can also be caused by a deviated nasal septum or an immune system deficiency.
While chronic rhinosinusitis is often associated with nasal polyps, you can also have it without polyps.
Also known as hay fever or seasonal allergies, allergic rhinitis is a group of symptoms affecting the nose. When someone inhales an allergen such as pollen or dust, their immune system reacts by releasing histamine and other immune system chemicals. This response causes symptoms such as:
Congestion
Runny nose
Sneezing
Itchy skin, mouth, or eyes
Symptoms are often seasonal and appear during specific times of the year, such as spring, summer, and early fall. But it’s possible to experience symptoms perennially (year-round).
Some people who experience allergic rhinitis–like symptoms don’t actually have allergies. This condition is known as nonallergic rhinitis.
While the triggers vary, they may include certain odors or irritants in the air, viral infections, hormone changes, weather changes, certain foods (such as hot or spicy foods and alcoholic beverages), and some medications (aspirin, ibuprofen, and beta-blockers, for example).
Your doctor may diagnose nonallergic rhinitis after ruling out allergic causes with a skin prick or blood test. But there may be other clues that you have nonallergic rhinitis: Your symptoms typically come and go year-round and don’t include the itchy nose, eyes, or throat associated with allergies.
Nonallergic rhinitis can also be linked to nasal polyps, but the only way to tell is to get a physical exam.
If sinus congestion and tenderness is limited to one side, you may have a deviated nasal septum. This occurs when the thin wall (nasal septum) between your nasal passages is off-center, making one nasal passage smaller.
As many as 80 percent of people have a nasal septum that’s slightly off-center, but if the deviation is pronounced, it can block airflow on one side of the nose and cause congestion.
The resulting inflammation may lead to repeat sinus infections, mouth breathing during sleep, and nosebleeds.
Another potential cause of single-sided congestion is sinus mucocele. Mucoceles are lesions (benign cystic growths) that gradually expand within the sinuses.
They can develop when the sinuses get blocked, leading the damaged tissue to build up. “It creates a cyst that continues to grow,” Dr. Griffiths says. If the cyst gets big enough, it can push into bone and even the eye socket, he notes. Symptoms often include:
Nasal congestion
Headaches
Facial pain
Nasal polyps often cause congestion, loss of smell, and sinus pressure, and can sometimes be mistaken for other sinus conditions.
Certain symptoms, like one-sided congestion, might suggest other conditions such as a deviated septum or sinus mucocele, which also warrant an exam by a healthcare provider.
If you suspect you have nasal polyps or a related condition due to persistent symptoms, see a healthcare provider for an accurate diagnosis.
