Does nasal polyps require a biopsy?

Written by Deng Bang Yu
Otolaryngology
Updated on April 25, 2025
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Nasal polyps are benign space-occupying lesions in our nasal cavity and sinus cavity. They primarily appear as a pineapple peel-like or half a lychee-like neoplasm. They lack blood vessels and nerves, so nasal polyps generally do not undergo biopsy unless there is suspicion of malignant transformation, in which case a biopsy is performed. Typically, nasal polyps are treated surgically by removing them during surgery, then the excised tissue is sent for pathological examination to determine if the polyps are benign or malignant. Therefore, generally speaking, nasal polyps do not undergo biopsy.

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Nasal Polyps Symptoms and Hazards

Nasal polyp symptoms are quite varied, and these mainly relate to the number of nasal polyps, the severity of the polyps, and the subjective feelings of the patient. If the nasal polyps are small, there may not be obvious clinical symptoms, and the patient might not feel any discomfort; these polyps might only be discovered during a physical examination. If there are more significant numbers of polyps, they can cause common clinical symptoms such as nasal congestion, runny nose, headache, dizziness, reduced sense of smell, and snoring during sleep. If the nasal polyps are severe, they might even lead to changes in the external shape of the nose, such as a saddle nose or a crooked nose, and in severe cases, they could induce comprehensive sinusitis.

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Can nasal polyps be cured without surgery?

Patients with nasal polyps usually cannot be completely cured without surgery. The formation of nasal polyps is mainly related to the patient's long-term smoking and drinking, pollution in the living environment, and stimulation from physical and chemical factors, which lead to the proliferation of nasal mucosal epithelium and edema. Patients with nasal polyps will have obvious symptoms such as nasal congestion, runny nose, headaches, and sinusitis. The use of medications to treat nasal polyps can only relieve symptoms such as nasal congestion. For a complete cure, functional endoscopic sinus surgery is required to remove the nasal polyps and open the sinus ostia, restoring the normal physiological environment of the nasal cavity, to achieve the therapeutic goal. (The use of medications should be under the guidance of a doctor.)

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Written by Li Mao Cai
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How to completely treat nasal polyps?

A thorough treatment for nasal polyps is surgical treatment; this includes a combination of post-surgical medication and regular follow-up examinations for a comprehensive treatment. First, it is important to identify the cause of the nasal polyps, which often stem from chronic inflammation in the nasal cavity or sinuses leading to mucosal polypoid changes and consequently, nasal polyps. For instance, common conditions like allergic rhinitis can also lead to nasal polyps over time. After removing the polyps through surgery, it is necessary to treat allergies as well, because without managing the allergies, the polyps might recur quickly. Additionally, after the surgery, it's important to conduct a pathological examination to check if there is an increase in eosinophil count; with more than 27% increase, the chance of recurrence is quite high. According to some reports, eosinophilic type nasal polyps have a recurrence rate of up to 90%. Therefore, regular postoperative reviews and cleanings are essential to prevent recurrence and are key to achieving a cure.

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Written by Deng Bang Yu
Otolaryngology
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How to check for nasal polyps

Nasal polyps are benign space-occupying lesions that occur in the nasal cavity and sinus cavities. There are several aspects to the examination of nasal polyps: Firstly, an anterior rhinoscopy examination can be performed. If the nasal polyps are large, or even protruding outside the nasal cavity, they can be directly seen. Anterior rhinoscopy enlarges the nasal cavity, allowing visualization of the middle nasal meatus and other tissues inside the nasal cavity. Secondly, a nasal endoscopy can be utilized. Nasal endoscopy is particularly effective for viewing polyps located deeper within, or at the back of the nasal passages, providing very clear visibility. Other examinations, such as electronic rhinoendoscopy, follow the same procedure. The third examination involves a sinus CT scan, which is helpful for identifying the origin of the nasal polyps, as well as the location, range, and extent of obstruction caused by the polyps. Another examination is the pathological examination after nasal polyp surgery, which aids in determining the origin and risk associated with the nasal polyps, as well as assisting in subsequent treatments.

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How to deal with enlarged nasal polyps?

Nasal polyps are a relatively common otolaryngological condition. First, it is necessary to assess the extent of the nasal polyps and the clinical symptoms. If the nasal polyps are few and the clinical symptoms are not particularly evident, this condition might be considered for conservative drug treatment, commonly involving nasal sprays and saline nasal irrigation. If there are many nasal polyps and more pronounced clinical symptoms, such as nasal congestion, thick nasal discharge, reduced sense of smell, headaches, and dizziness, and if standardized drug treatment is ineffective, then surgical treatment should be considered. Currently, the most commonly used procedure is endoscopic nasal polyp removal surgery, with regular follow-ups required to monitor postoperative recovery. (The use of medications should be under the guidance of a doctor.)