Private nasal polyps clinic in London, same-day ENT.

Symptoms

• Persistent blocked nose, often both sides, not relieved by decongestants
• Reduced or absent sense of smell, and with it a loss of taste — frequently the symptom people mind most
• runny nose, or mucus dripping down the back of the throat
• facial pressure or fullness, and reduced sleep quality with snoring
• recurrent sinus infections
• symptoms present for more than twelve weeks — which distinguishes this from an ordinary cold

Treatment

• Steroid nasal spray — the mainstay, used daily and indefinitely rather than in short bursts. It shrinks polyps and prevents regrowth.
• Technique determines whether it works. Look down, aim the nozzle outwards towards the ear on that side, use the opposite hand, and breathe in gently without sniffing. Aiming up the middle causes nosebleeds and delivers nothing to the polyps.
• Steroid drops are more effective than spray for larger polyps, and are usually given in the head-down-and-forward position so they reach the roof of the nose.
• Saline rinsing before the steroid, once or twice daily, using cooled boiled or distilled water.
• A short course of steroid tablets can shrink polyps rapidly and restore smell, but the effect is temporary and courses cannot be repeated often.
• Biologic injections are now available for severe recurrent polyps, particularly with asthma, and have transformed outcomes for people who previously faced repeated surgery.

Surgery

Endoscopic sinus surgery removes polyps and opens the sinuses, and is considered where medical treatment has not controlled symptoms. It improves blockage substantially and often restores smell — but it is not a cure. Polyps recur in a significant proportion within a few years, and the single biggest determinant of how long the benefit lasts is whether you continue the steroid spray and rinsing afterwards. Many people stop once they can breathe, and the polyps return.

Smell

Loss of smell affects appetite, enjoyment of food, and safety — you may not detect gas, smoke or spoiled food. Fit smoke alarms and check food dates rather than relying on smell. Smell training — deliberately sniffing four distinct scents twice daily for several months — has reasonable evidence and is worth doing alongside treatment.