Polyps

Most patients develop progressive nasal congestion , often over several years. Eventually, polyps can cause recurrent sinusitis, loss of smell, facial pain and chronic nasal congestion.

Nasal polyposis is diagnosed by medical history combined with direct nasal examination with or without endoscopy. A CT scan of the sinuses may be necessary to assess the severity of the disease and/or to plan surgery.

As polyposis is associated with other medical conditions, depending on the medical history it is wise to evaluate the patient for these conditions:

1. Environmental allergies: a skin allergy test to determine which allergies are present

2. Asthma: a pulmonary function test may be required to assess the presence of asthma

3. Laryngopharyngeal reflux: it is useful to perform a throat endoscopy to assess the presence of reflux.

Some patients with severe nasal polyposis have immune predispositions associated with immunoglobulin E or eosinophils. These abnormalities can be identified by a blood test.

Treatment of nasal polyposis involves two major elements: treatment of the disease and treatment of associated medical conditions.

To control nasal polyposis, it's important to practice goodnasal hygiene combined with daily use of nasal corticosteroids. When an infection is suspected, it is necessary to treat with antibiotics, as sinusitis can be more easily complicated in patients with polyposis.

Treatment of associated medical conditions is generally as follows:

1. Allergies: antihistamines for prevention during exposure or in season, with or without desensitization

2. Asthma: regular use of inhalers with or without stabilizers to prevent deterioration and inflammation

3. Laryngopharyngeal reflux: continuous treatment of reflux with proton inhibitors or other therapy

Nasal polyposis is a chronic disease and is prone to recurrence: it is therefore important to be faithful to the various aspects of treatment and to have regular ENT follow-up.

Thanks to technological and pharmaceutical advances, biological agents now make it possible toavoid surgery. This type of treatment has long been used for asthma and skin problems, and when polyposis recurs after surgery. It is now available in combination with a nasal corticosteroid as an alternative to surgery. The medication is taken as an injection, has a proven safety profile with over a million patients, and is covered by most insurance plans.

The efficacy of this type of medication varies from 1 to 6 months. Although there is no guarantee that patients will regain their sense of smell, the majority report significant improvement within 6 months. By following a regular overall treatment regimen and performing the necessary follow-ups, the majority of patients are able toavoid surgery.

When unilateral polyps are present, when medical treatment is no longer effective, when the patient has repeated infections or when the polyps have become too obstructive, endoscopic sinus surgery is required.

Once surgery has been performed, it is important to continuenasal hygiene and the daily use of nasal corticosteroids. In some patients with more severe disease, it may also be necessary to use immunomodulatory medication to prevent regrowth and repeat surgery.

Using state-of-the-art medication and techniques, Dr. Brousseau performs endoscopic sinus surgery under analgesia and local anesthesia in the office, without general anesthesia. This means that patients do not need to fast the day before surgery, and do not require intubation. Surgery is done strictly through the nostrils using a rigid endoscope, so there's no incision, external scarring or effect on your face. Surgery takes between 60 and 90 minutes, depending on the extent of the disease and its complexity. Thanks to this technique, the vast majority of our patients return to work the same day immediately after surgery.

Nasal polyposis is a chronic inflammatory disease of the upper respiratory tract. Even after surgery, polyps can grow back if inflammation is not kept under control. That's why it's so important not only to treat the polyps, but also to treat any associated medical conditions present in the patient. Regular , long-term clinical follow-up is also important to ensure adequate disease control, avoid infection and potentially avoid the need for re-operation. We offer follow-up services for all the patients we operate on, and for all those who have already had this diagnosis. We also have a medical treatment program with biological agents for polyposis patients who wish to avoid surgery or have recurrent disease.

Most of the time, you can get an appointment the week after you contact us and get a surgery date the week after your visit.

You do not need a referral from your doctor to consult Dr. Brousseau.