Nasal Polyps on CT: What Does the Scan Show and What Comes Next?

Nasal polyps on CT means the scan shows soft-tissue swellings in the nose or sinuses that look like polyps. Polyps are soft, painless, non-cancerous growths that usually form on both sides and are linked to long-term inflammation, most often chronic sinusitis. The scan shows where they are and how far they extend; a clinician usually confirms them by examining the nose.

This guide is for adults reading a CT report that mentions polyps or polypoid tissue. It explains common terms and questions to ask. It cannot interpret your own scan or decide your treatment.

Polyps themselves are rarely an emergency. Cleveland Clinic notes that sinus infections linked to polyps can rarely spread to the eye socket or brain. It advises seeking medical attention right away for signs of a serious infection, including:

• a fever above 103°F (40°C);
• confusion or other changes in mental state;
• vision changes, especially with pain or swelling around the eyes;
• a stiff neck or seizures.

Polyps from chronic sinus inflammation usually appear on both sides. Cleveland Clinic states that a single growth on one side is not typical of a polyp and could be a tumour of the nose or sinuses, so it should be reported to a clinician.

The NHS lists symptoms that should be checked, such as a blocked nose on one side that does not go away, nosebleeds, mucus with blood in it, double vision, a watering or bulging eye, facial pain or numbness that does not go away, and loosening teeth. The NHS stresses that these symptoms are common and often caused by other conditions. If your report or symptoms are one-sided, ask whether the growth will be examined directly and whether a tissue sample is needed.

Small polyps may cause no symptoms. Larger ones can block the nose and sinuses. The NHS, MedlinePlus and Cleveland Clinic describe symptoms such as:

Unlike a cold, which usually clears within days, the NHS notes that polyps will not get better unless they are treated. The NHS suggests seeing a GP if you think you may have polyps, have difficulty breathing, notice changes to your sense of smell or find your symptoms are getting worse. MedlinePlus advises contacting a provider if you often have trouble breathing through your nose.

• a blocked or runny nose that feels like a cold that never clears;
• mucus dripping down the back of the throat;
• a reduced sense of smell or taste;
• facial pressure or headache, especially with a sinus infection;
• snoring and repeated sinus infections.

Chronic sinusitis means inflammation of the nose and sinuses with symptoms lasting at least 12 weeks. Cleveland Clinic describes it as the most common reason polyps develop. When polyps are present, specialists often use the term chronic rhinosinusitis with nasal polyps.

Polyps are more common in people with asthma, hay fever or allergies, sensitivity to aspirin or certain other anti-inflammatory painkillers, and cystic fibrosis. The NHS notes that polyps are rare in children.

Knowing about linked conditions can matter for your care. For example, polyps that block the nose can be associated with more frequent asthma attacks, according to Cleveland Clinic, so tell the team treating your polyps about any asthma, and the team treating your asthma about the polyps.

MedlinePlus explains that on a sinus CT, polyps appear as cloudy areas in the sinuses, and longer-standing polyps may show changes in the nearby bone. Cleveland Clinic describes CT or MRI as a way to show the size and location of polyps when more detail is needed.

The scan is one part of the picture. Diagnosis usually rests on the history and a nasal endoscopy, in which a thin tube with a camera and light is passed into the nose. Allergy testing may also be suggested.

Treatment choices depend on symptoms, the size of the polyps and other conditions such as asthma. In outline, the cited sources describe:

Treatment usually controls polyps rather than removing the tendency to form them. MedlinePlus notes that surgery often makes breathing easier, but a reduced sense of smell or taste does not always improve. Cleveland Clinic adds that some people need ongoing treatment or repeat surgery. Ask how long a treatment should be tried before its effect is judged, and how follow-up will be arranged.

• steroid nasal sprays or drops, usually the first option to shrink polyps, with effects that tend to wear off when they are stopped;
• salt water rinses, which a pharmacist can advise on;
• a short course of steroid tablets in some cases;
• biologic injections for some people with severe or recurring polyps;
• endoscopic sinus surgery if medicines do not help or polyps are large. The NHS notes polyps commonly grow back, often within a few years, so ongoing spray treatment may be advised.

Bring the CT report and a list of your symptoms and medicines. Do not stop or change a prescribed medicine, including steroid sprays or tablets, without talking to the prescriber.

• Are the polyps on both sides or one side, and has the inside of my nose been examined with a camera?
• Does the CT show anything other than polyps that needs follow-up?
• Is this chronic rhinosinusitis with nasal polyps, and could asthma, allergy or aspirin sensitivity be involved?
• Which treatment would you try first, and how will we know if it is working?
• When would surgery or a referral to an ENT specialist be considered?
• Which symptoms should make me contact you sooner?

On SameCase, patients and verified doctors share de-identified cases. Reading how people with similar CT findings described their symptoms and which questions they asked can help you plan your own appointment. Similar cases cannot diagnose you or predict how you will respond to treatment; your care team makes those decisions with your full history.