These sections discuss special situations that stem from CAID symptoms and/or their treatment, and as they relate to various other disorders.
CAID itself can cause an anatomical change to the interior of the nose. I frequently see patients who have developed nasal polyps; benign tumors that occur when chronic inflammation causes the membranes of the sinuses and nose
to swell and form individual or multiple polyps. Nasal polyps can be as small as the tip of a ballpoint pen or as large as a grape. Even small polyps can obstruct sinus openings, which can further aggravate sinusitis. It is one of the worst forms of chronic sinusitis and often occurs when there are issues relating to asthma, allergies, and - in the most aggressive variant - allergy to aspirin.
Polyps can be diagnosed with a computed tomography (CT) scan or by nasal endoscopy, an office procedure in which your ear, nose, and throat (ENT) physician will either place a rigid or a flexible lighted tube (endoscope) into your nose to examine the nasal and sinus passages. To reduce the size of nasal polyps so that breathing can return to normal, you must break the inflammatory cycle. As mentioned, polyps are caused by inflammation, which is caused by infection. I often prescribe nasal steroid sprays or oral steroids, such as prednisone, to reduce inflammation. Topical steroids via irrigation or nebulizer can be a beneficial treatment as well. Antibiotics and/or oral or topical antifungal drugs can also help eliminate any underlying infection. If you have allergies, antihistamines may be required as well.
Polyps may need to be surgically removed if drugs don’t help. This outpatient procedure can be performed with local anesthesia, and is discussed further in category 12. What’s more, polyps tend to recur, so medication must be continued even after surgery to control them. When they start to grow back, your physician should remove them along with any related infection. I recommend to all of my patients
with polyp disease to irrigate daily and use various medicines on a consistent basis.