Nasal polyps occur almost exclusively in children with cystic fibrosis, usually bilateral.
Often an inferior turbinate, possibly enlarged due to rhinitis, can be mistaken for nasal polyposis. The vast majority of children referred to exclude a nasal polyp have normal nasal anatomy.
Malignancy is very rare and usually has other, red flag symptoms, for example proptosis and diplopia, ulceration, bleeding and is usually unilateral.
Polyps vs turbinates:
- Polyps are insensate
- Polyps are soft and mobile, turbinates have a bony core, so are not
- Polyps have a translucent, gelatinous appearance, turbinates are pinker in colour.
C.M. & G.T – 6-10-26
- Initiate medical management as outlined below first.
- Please refer with a photograph of the suspicious area.
- Nasal polyps occur almost exclusively in children with cystic fibrosis-bilateral.
- Refer to medical paediatrics.
- Malignancy very rare – unilateral mass suspicious (see Rhinosinusitis (Adult) – RefHelp) for further detail of cancer presentations.
- If unilateral mass (that is not a polyp or turbinate and shows red flags) refer ENT urgently.
- If medical management of genuine polyposis unsuccessful, refer to medical paediatrics/allergy team.
If polyp suspected on the background of allergic rhinitis/asthma:
- Treat medically if troublesome:
- Nasal saltwater rinses or sprays
- Nasal steroid spray
- Oral antihistamine of choice.
