Ear, nose & throat · UKMLA & AKT

Nasal polyps

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise nasal polyps — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Nasal obstruction - bilateral, progressive, often worse at night; most common symptom
  • Anosmia/hyposmia - blockage of olfactory cleft; may precede visible obstruction
  • Rhinorrhoea - clear/mucoid; postnasal drip common
  • Facial pressure/pain - suggests concurrent sinusitis; polyps alone rarely painful
  • Examination - pale, grey, translucent, smooth, soft, insensate ("peeled grapes"); insensate and mobile unlike turbinates which are bony and tender

Unilateral nasal polyp = red flag. Must be referred urgently to ENT to exclude malignancy regardless of other symptoms. Bilateral polyps are usually benign/inflammatory and can be managed in primary care initially.

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