Modern treatment options for nasal polyps
What are polyps?
Nasal polyps are local swellings in the inner lining (mucosa) of the nose, which protrude like pressed grapes into the narrow nasal cavities. This is a chronic inflammation of the nose and is not a tumor. They are usually numerous and are located in both nostrils. Polyps prevent breathing and smelling and block the openings of the facial sinuses, causing inflammation (such as sinusitis).
Where are they caused?
We do not know the cause of polyps. The old view that they are due to allergies, we now know that is not true. Sometimes an allergy coexists, but this is not the cause that created them. Most of the time, polyps are characterized by a local inflammation, in which a type of cell called eosinophils plays an important role. The same eosinophilic inflammation that causes nasal polyps can cause asthma in the lungs, so it is very important to treat them before they develop into a lung disease.
How are they treated?
The initial treatment is with local treatment with nasal cortisone sprays. If this is not enough to control the disease, then they will need to be removed surgically. Modern operations for polyps are performed with the help of endoscopes, high-resolution cameras and special high-tech tools. Endoscopic surgery, which is often combined with the use of intraoperative navigation (Navigation), in specialized hands is completely effective and safe. Its purpose is to clean the nose of all pathological tissue, but also to open the narrow openings of the sinuses, so that they can then be accessible for local treatment with cortisone solutions.
New Therapies
For the treatment of nasal polyps, new drugs called monoclonal antibodies or biologic agents have recently been approved by the FDA and EMA. These drugs interfere with the molecular mechanisms of eosinophilic inflammation and cause polyp shrinkage, resulting in a dramatic improvement in the symptoms and quality of life of patients, while also improving asthma, where present.
The Athens Rhinology Center, at the Athens Medical Center, has been a specialized reference center for the treatment of nasal polyps for more than ten years, and is the first Greek center to implement treatment with biologic agents, currently having the largest series of patients with nasal polyps undergoing treatment with biologic agents in Greece.
| The surgical treatment of polyps is performed using endoscopic surgery. With the help of high-resolution (4K) endoscopes/cameras and special tools, all pathological tissue is removed completely and the sinuses are opened, so that local treatment is possible. Intraoperative navigation offers significant assistance in the operation, which projects the surgical instrument into the patient’s CT scan during the operation. The image shows a typical operating room layout at the Athens Medical Center, with the surgical camera screen on the right and the Navigator screen on the left. |
