Treating Chronic Rhinosinusitis with Nasal Polyps

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Welcome

Chronic rhinosinusitis with nasal polyps is a condition that can cause sinus and nose stuffiness and loss or change of smell that interferes with your quality of life. If you’ve had symptoms that continue to bother you, treatment may help. This tool prepares you to talk with your otolaryngologist (ENT) or allergist to decide what treatments are best for you.

The tool is easy to use:
- Read about different treatment options.
- Respond to a few simple statements based on your lifestyle and preferences.
- Print out your answers and bring them to your next appointment, or have them in front of you for a telehealth appointment.

About Chronic Rhinosinusitis with Nasal Polyps

People with chronic rhinosinusitis (sinus and nose stuffiness that bothers you) have a one in four – or greater – chance of developing nasal polyps. Nasal polyps are growths in the lining of the nose or sinuses. Although they are most common in people 40 to 60 years old or who have asthma, anybody can develop nasal polyps. While nasal polyps are not cancerous, they are uncomfortable and can make you miserable. For months or even years you may have had a stuffy nose, loss of smell, facial pressure, or nasal drainage. These problems can interfere with your quality of life.

Nasal polyps are diagnosed by a nasal endoscopy (a tiny camera inserted in the nose) and/or CT scan (an image of the nose and sinuses). There are a variety of treatment options for nasal polyps, ranging from nasal sprays to surgery to newer medications called biologics. Your doctor may offer different options depending on whether this is the first time you’ve sought treatment, or you’ve been treated with sinus surgery and it is no longer helping.

If you are seeking care for your nasal polyps for the first time

If you have had sinus surgery for nasal polyps but they came back

First-time Treatment for Nasal Polyps

If this is the first time you are getting treated for nasal polyps, you and your doctor will talk about several options. Together you will choose which treatment option works best for you, based on your health and your lifestyle. You may have better success if you use several treatments at the same time. Talk with your doctor about what treatment or combination of treatments might work best for you.

This chart explains more about your treatment options.
How are they used?

Taken by nasal spray or nasal wash

What are the advantages?

Simple to use

There are several over-the-counter options

Inexpensive

What are the possible side effects and disadvantages?

May cause nosebleeds

Burning, stinging or crusting in the nose

Bleeding from the nose

May not reduce the size of large polyps enough to improve symptoms

May not work for large polyps

Must be used twice a day, every day

What is your cost for the treatment?

$

Work with your doctor to determine what it will cost based on your insurance

What else should I know?

Corticosteroid medication is usually the first option for nasal polyps

There are several brands of corticosteroids

You also may benefit from receiving oral corticosteroids and antibiotics for a short time
How is it used?

Corticosteroid medication taken by breath-powered delivery system into the nose.

See how it’s done

What are the advantages?

May reach areas of the sinuses better than corticosteroid sprays

What are the possible side effects and disadvantages?

Requires breathing coordination and may be difficult if you are unable to strongly breathe out

Must be used every day

What is your cost for the treatment?

$$

Work with your doctor to determine what it will cost based on your insurance

Financial assistance may be available

What else should I know?

Only available in one corticosteroid type, fluticasone
How is it used?

Tiny instruments and a camera are inserted through your nostrils and the polyps are removed

What are the advantages?

Removes the polyps

May make the sinus opening larger to help delivery of medications

One-time cost

What are the possible side effects and disadvantages?

You likely will need to continue using corticosteroid sprays

You may also need to take biologics to get long-term relief

What is your cost for the treatment?

$$$

Work with your doctor to determine what it will cost based on your insurance

Financial assistance may be available

What else should I know?

Surgery is usually an option only if corticosteroid sprays and a short course of oral steroids don’t work

May not be a good option for those who have poor lung function, certain heart conditions, or other health conditions
How are they used?

Injected under the skin every two to four weeks

For DUPIXENT, you will inject it yourself every two weeks

For XOLAIR, you will go to the doctor’s office to get the injection every two or four weeks (discuss with your physician)

For NUCALA, you will inject it under the skin yourself under the skin every four weeks

What are the advantages?

May be a good option for those who have had multiple surgeries without benefit or who cannot have surgery due to poor lung function, certain heart conditions, or other health conditions

May help if symptoms continue after surgery

What are the possible side effects and disadvantages?

You may need to take the therapy long term to achieve continued relief

Because these treatments are newer, there is no long-term information about safety

You may need to continue taking corticosteroids

You still may need to have surgery

Xolair may cause an allergic reaction, including one that may be life-threatening (anaphylaxis, rare)

What is your cost for the treatment?

$$$$

Work with your doctor to determine what it will cost based on your insurance

Financial assistance may be available

What else should I know?

Biologic treatment is usually an option only if corticosteroid sprays and a short course of oral steroids don’t work or if you are unable to have surgery

If you have asthma or eczema (atopic dermatitis), a biologic may be a good option because it might help all three conditions
Treatment for Nasal Polyps That Have Recurred After Sinus Surgery

If you’ve had surgery and your nasal polyps have come back, you and your doctor will talk about several options to provide relief, including another surgery. Together you will choose which treatment option works best for you, based on your health and your lifestyle. You may have better success if you use more than one treatment at the same time, especially if your condition is more severe or you have moderate or severe asthma.

This chart explains more about your treatment options.
How are they used?

Taken by nasal spray or nasal wash

What are the advantages?

Simple to use

There are several over-the-counter options

Inexpensive

What are the possible side effects and disadvantages?

May cause nosebleeds

Burning, stinging or crusting in the nose

Bleeding from the nose

May not reduce the size of large polyps enough to improve symptoms

May not work for large polyps

Must be used twice a day, every day

What is your cost for the treatment?

$

Work with your doctor to determine what it will cost based on your insurance

What else should I know?

You also may benefit from receiving oral corticosteroids and antibiotics for a short time
How is it used?

Corticosteroid medication taken by breath-powered delivery system into the nose

See how it’s done

What are the advantages?

Medication may reach areas of the sinuses better than corticosteroid sprays

What are the possible side effects and disadvantages?

Requires breathing coordination and may be difficult if you are unable to strongly breathe out

Must be used every day

What is your cost for the treatment?

$$

Work with your doctor to determine what it will cost based on your insurance

Financial assistance may be available

What else should I know?

Only available in one corticosteroid type, fluticasone
How is it used?

You may need another surgery, in which polyps are removed by inserting tiny instruments and a camera through your nostrils

What are the advantages?

Removes the polyps

May help delivery of medications into the sinuses

One-time cost

What are the possible side effects and disadvantages?

You may need to continue taking corticosteroid sprays

You may also need to take biologics to get long-term relief

What is your cost for the treatment?

$$$

Work with your doctor to determine what it will cost based on your insurance

Financial assistance may be available

What else should I know?

May not be a good option for those who have poor lung function, certain heart conditions, or other health conditions
How are they used?

For DUPIXENT, you will inject it yourself every two weeks

For XOLAIR, you will go to the doctor’s office to get the injection every two or four weeks (discuss with your physician)

For NUCALA, you will inject it under the skin yourself under the skin every four weeks

What are the advantages?

May be a good option for patients who cannot have surgery due to poor lung function, certain heart conditions, or other health conditions

What are the possible side effects and disadvantages?

You may need to take the therapy long-term to achieve continued relief

You may need to continue taking corticosteroids

You still may need to have surgery

Xolair can cause an allergic reaction, including one that may be life-threatening (anaphylaxis, rare)

What is your cost for the treatment?

$$$$

Work with your doctor to determine what it will cost based on your insurance

Financial assistance may be available

What else should I know?

If you have asthma or eczema (atopic dermatitis), a biologic may be a good option because it might help all three conditions
How are they used?

Tiny steroid-coated implants called stents are placed in your sinuses and the drug is slowly released

The stents dissolve over several weeks

What are the advantages?

Can be done in the doctor’s office

What are the possible side effects and disadvantages?

The implant effect lasts several months. Therefore, you may need to have repeated procedures.

You may need to continue taking corticosteroids by nasal spray or nasal rinse

What is your cost for the treatment?

$$-$$$

Work with your doctor to determine what it will cost based on your insurance

Financial assistance may be available

What else should I know?

This is an option only after sinus surgery.

May need to be repeated

Get Results!

Print out your answers and bring them to your next appointment with your ENT or allergist or have them in front of you for a telehealth appointment.

Treating Chronic Rhinosinusitis with Nasal Polyps

In partnership with

Supported by

Welcome

The tool is easy to use:

About Chronic Rhinosinusitis with Nasal Polyps

If you are seeking care for your nasal polyps for the first time

If you have had sinus surgery for nasal polyps but they came back

First-time Treatment for Nasal Polyps

Corticosteroid nasal spray or rinse

Fluticasone breath-powered corticosteroid device (Xhance ® )

Surgery

Biologics Dupilumab (Dupixent®), Omalizumab (Xolair®), or Mepolizumab (NUCALA®)

Treatment for Nasal Polyps That Have Recurred After Sinus Surgery

Corticosteroid nasal spray or rinse

Fluticasone breath-powered corticosteroid device (Xhance ® )

Surgery

Biologics Dupilumab (Dupixent®), Omalizumab (Xolair®), or Mepolizumab (NUCALA®)

Sinus implants (Sinuva ® )

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