Should nasal polyps be removed immediately?

Nasal polyps are mainly caused by mucosal inflammation of nasal cavity and paranasal sinuses, and inflammatory edema tissue protruding into the cavity is formed during the repair process, which is the result of chronic inflammatory reaction of nasal cavity. Most people have nasal polyps on both sides at the same time, but it can also happen unilaterally. Should nasal polyps be removed immediately when they grow? Not necessarily. If the nasal polyp is very small, but it is found that the polyp does not affect the nasal ventilation during physical examination, and the patient has no discomfort, then there is no need for special treatment, especially for children, and observation and drug treatment can be given priority to. Commonly used drugs are glucocorticoid nasal spray (such as Raynaud, Frizonase, Nesuna, etc. ), oral glucocorticoid (prednisone, dexamethasone, etc. ), macrolides, antihistamines, etc. However, early surgical treatment should be considered if: some nasal polyps will gradually develop from single to multiple, and some even start with multiple polyps, invading multiple parts of the nasal cavity or even the whole group of paranasal sinuses; Some even dilate the nasal cavity to form a "frog nose"; Or some nasal polyps block the posterior nostril, causing difficulty in breathing through the nose, blocking the eustachian tube, causing tinnitus and hearing loss. At present, functional endoscopic sinus surgery is a recognized standard operation for the treatment of nasal polyps. The operation is accurate, minimally invasive, does not destroy the normal structure, has a high cure rate, and the recurrence rate is obviously lower than that of the traditional operation. Can nasal polyps recur after treatment? Postoperative recurrence may still occur. Some medical advertisements say that the digital ultra-minimally invasive nasal endoscopic system does not require surgery to treat nasal polyps, and it is not easy to relapse with minimally invasive surgery, and some even say "never relapse". This is unscientific. Generally speaking, 75% ~ 85% patients with nasal polyps can basically be cured without recurrence after surgery and standardized treatment after operation. In order to reduce the recurrence as much as possible, patients should continue to take drugs after operation, including nasal lavage, nasal spray with glucocorticoid and macrolides such as erythromycin and clarithromycin. Studies have proved that the use of glucocorticoid nasal spray after operation is beneficial to inhibit nasal mucosal remodeling, promote mucosal epithelization and reduce the recurrence of polyps; Long-term and low-dose use of macrolides can inhibit nasal mucosal inflammation, promote mucosal recovery, reduce postoperative nasal secretions and effectively prevent the recurrence of polyps.