Abstract

NASAL POLYPS (NASHA ARSHA) PATHOPHYSIOLOGY, DIAGNOSIS, AND EMERGING TREATMENT STRATEGIES – A COMPREHENSIVE REVIEW

Ankit Sharma*, Siva Kumar C. S.

Abstract

Nasal polyps, also known as Nasha Arsha, are non-cancerous, inflammatory growths that develop from the sinonasal mucosa and are commonly linked to chronic rhinosinusitis. These polyps can considerably diminish quality of life by causing nasal blockage, impairment of the sense of smell, and frequent infections. The pathology of nasal polyps is characterized by persistent inflammation, dysfunction of the epithelial barrier, and immune system imbalances, primarily influenced by type 2 cytokine responses. Several factors can increase the risk of developing nasal polyps, including chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, allergic rhinitis, aspirinexacerbated respiratory disease (AERD), and genetic factors. The diagnosis of nasal polyps typically relies on clinical evaluation and is supported by procedures such as nasal endoscopy, imaging techniques like computed tomography (CT), and histopathological examination. Standard treatment modalities often incorporate intranasal corticosteroids, oral corticosteroids, antibiotics, and biologic therapies that target interleukin pathways. For cases that are recurrent or resistant to other treatments, functional endoscopic sinus surgery (FESS) is frequently suggested. Newer treatment options, such as gene therapy and modifications of the microbiome, show potential in managing disease persistence and recurrence. In Ayurvedic medicine, nasal polyps are referred to as Nasha Arsha, with their formation being attributed to imbalances in the Kapha and Vatadoshas. Ayurvedic treatment approaches may include Nasya therapy, which involves the use of medicated nasal oils, herbal remedies like Triphala, Haridra (turmeric), and Pippali (long pepper), as well as Panchakarma therapies such as Vamana (therapeutic vomiting) and Virechana (purification therapy). In addition, dietary changes and lifestyle adjustments are advocated for long-term management and disease prevention. This overview delves into the pathophysiology, risk factors, diagnostic methods, and innovative treatment options for nasal polyps, highlighting the importance of understanding these elements to develop effective therapies and enhance patient care. A multidisciplinary approach that combines conventional and holistic treatments may pave the way for more successful and enduring treatment solutions. Ongoing research into the interplay between these various treatment strategies is essential for improving patient outcomes.

Keywords: Nasal polyps, Nasha Arsha, Chronic Rhinosinusitis, Ayurvedic Treatment, Nasya Therapy, Functional Endoscopic Sinus Surgery.