Surgical Treatment of Nasal Polyposis

Nasal polyposis represents the end point of multiple inflammatory pathways. Radiological findings for polyposis demonstrate benign-appearing expansile lesions with soft tissue attenuation, occasional evidence of bony rarefaction, and rare evidence of bony erosion. When appropriately directed medical management, including topical and oral corticosteroids, culture-directed antibiotics, and specific treatments (e.g., immunotherapy), either fails or is contraindicated, surgery is warranted in the symptomatic patient with nasal polyps. Meticulous dissection with mucosa-sparing techniques during functional endoscopic sinus surgery can successfully eliminate polypoid disease; however, in the absence of postoperative care and medical management, recurrence is highly likely within a variable period of time. Accordingly, surgery should always be combined with appropriate medical management.