Editing Nasal polyp (section)

==Treatment==
The first line of treatment for nasal polyps is topical [[steroid]]s.<ref name="Cour2016" /> Steroids decrease the inflammation of the sinus mucosa to decrease the size of the polyps and improve symptoms.<ref name="Cour2016" /> Topical preparations are preferred in the form of a nasal spray but are often ineffective for people with many polyps. Steroids by mouth often provide drastic symptom relief, but should not be taken for long periods of time due to their side effects. Because steroids only shrink the size and swelling of the polyp, people often have recurrence of symptoms once the steroids are stopped.<ref name="Cour2016" /> Decongestants do not shrink the polyps, but can decrease swelling and provide some relief.<ref name="Peds2016" /> Antibiotics are only recommended if the person has a co-occurring [[bacterial infection]].<ref name="Mid2014" />

In people with nasal polyps caused by aspirin or NSAIDs, avoidance of these medications will help with symptoms. Aspirin desensitization has also been shown to be beneficial.<ref name="Cour2016" />

===Surgery===
[[File:TSESI.jpg|thumb|Professor Heinz Stammberger, known as the father of endoscopic sinus surgery, teaching the technique at Tarabichi Stammberger Ear and Sinus Institute.]]
[[File:Effect of Long Nozzle.jpg|thumb|left|CT scan images after application of radioactive laced nasal steroids using long nozzle. Note the reach of the medication into the area where nasal polyps originate]]
[[Functional endoscopic sinus surgery|Endoscopic sinus surgery]], advocated and popularized by Professor Stammberger, is often very effective for most people, providing rapid symptom relief. Endoscopic sinus surgery is minimally-invasive and is done entirely through the nostril with the help of a camera. Surgery should be considered for those with complete nasal obstruction, uncontrolled runny nose, nasal deformity caused by polyps or continued symptoms despite medical management.<ref name="Peds2016" /> Surgery serves to remove the polyps as well as the surrounding inflamed mucosa, open obstructed nasal passages, and clear the sinuses. This not only removes the obstruction caused by the polyps themselves, but allows medications such as saline irrigations and topical steroids to become more effective.<ref name="Cumm2015">{{Cite book |last=Soler |first=Zachary |title=Cummings Otolaryngology |publisher=Mosby/Elsevier |year=2015 |isbn=978-0323052832 |pages=702–713}}</ref> It has been suggested that one of the main objectives in sinus surgery for polyps is to allow delivery of the steroids into those areas of the sinuses where polyps develop, namely, the ethmoid sinuses. Specially designed long nozzles had been developed to use postoperatively to deliver steroids into those areas after sinus surgery for polyps.<ref>{{Cite journal |last=Kapadia |first=Mustafa |last2=Grullo |first2=Precious Eunice R. |last3=Tarabichi |first3=Muaaz |date=2019-05-07 |title=Comparison of short nozzle and long nozzle spray in sinonasal drug delivery: a cadaveric study |journal=Ear, Nose & Throat Journal |volume=98 |issue=7 |pages=E97–E103 |doi=10.1177/0145561319846830 |issn=0145-5613 |pmid=31064245 |doi-access=free}}</ref>

Surgery lasts approximately 45 to 60 minutes and can be done under general or local anesthesia.<ref name="Cumm2015" /> Most people tolerate the surgery without much pain, though this can vary from person to person. The person should expect some discomfort, congestion, and drainage from the nose in the first few days after surgery, but this should be mild.<ref name=":0">{{Cite web |title=Endoscopic Nasal & Sinus Surgery |url=http://care.american-rhinologic.org/ess |url-status=dead |archive-url=https://web.archive.org/web/20171222004443/http://care.american-rhinologic.org/ess |archive-date=2017-12-22 |access-date=2017-12-13 |website=care.american-rhinologic.org}}</ref> Complications from endoscopic sinus surgery are rare, but can include bleeding and damage to other structures in the area including the eye or brain.<ref name=":0" />

Many physicians recommend a course of oral steroids prior to surgery to reduce mucosal inflammation, decrease bleeding during surgery, and help with visualization of the polyps.<ref name="Cour2016" /> Nasal steroid sprays should be used preventatively after surgery to delay or prevent recurrence.<ref name="Peds2016" /> People often have recurrence of polyps even following surgery. Therefore, continued follow up with a combination of medical and surgical management is preferred for the treatment of nasal polyps.<ref name="Cour2016" />