CONDITION

Nasopharyngeal Polyps

Why this matters now

Nasopharyngeal polyps are most commonly diagnosed in young cats, typically between 1 and 5 years of age, though they can occur in kittens as young as a few months. The cause remains unclear, though some association with previous upper respiratory infections has been suggested.

Polyps tend to grow slowly but progressively. A small polyp may cause minimal signs initially, but as it enlarges, respiratory obstruction or ear problems typically worsen. Without treatment, signs generally do not resolve spontaneously and tend to become more pronounced over time.

Signals & patterns

Early signals

Noisy breathing

Snoring, stertor (snorting sounds), or increased breathing noise, particularly during sleep, may be among the first signs.

Nasal discharge

Discharge from one or both nostrils may develop, sometimes appearing purulent if secondary infection occurs.

Frequent sneezing

Cats may sneeze repeatedly as the polyp irritates the nasopharyngeal region.

Head shaking or ear scratching

If the polyp extends into the ear canal, cats may show ear discomfort or frequent ear-directed behaviour.

Later signals

Obvious respiratory obstruction

Cats may breathe predominantly through the mouth or show laboured breathing as the polyp blocks airflow.

Ear discharge

Brown or purulent discharge from the ear canal suggests extension of the polyp into the external ear.

Head tilt

If the middle ear is affected, vestibular signs including head tilt may develop.

Difficulty swallowing

Large nasopharyngeal polyps can interfere with normal swallowing or cause voice changes.

Click to read about the biological mechanisms

How this is usually investigated

Diagnosis of nasopharyngeal polyps typically involves examination under anaesthesia and may include imaging to assess the full extent of the growth.

Oral and nasopharyngeal examination under anaesthesia

Purpose: Retracting the soft palate allows direct visualisation of polyps extending into the nasopharynx.
Considerations: Requires general anaesthesia. Often diagnostic if a polyp is visible and accessible.

Otoscopic examination

Purpose: Examines the ear canal for polyps extending through the tympanic membrane.
Considerations: Helpful when ear signs predominate. May reveal polyp tissue behind or bulging the eardrum.

CT or MRI imaging

Purpose: Provides detailed assessment of the middle ear and skull base to determine polyp extent and plan surgery.
Considerations: Particularly useful when middle ear involvement is suspected or recurrence occurs.

Histopathology

Purpose: Examination of removed tissue confirms the benign inflammatory nature and rules out other masses.
Considerations: Usually performed on removed polyp tissue to confirm diagnosis.

Options & trade-offs

Treatment of nasopharyngeal polyps is surgical, with the approach depending on polyp location and extent.

Traction avulsion

The polyp is grasped and carefully pulled to remove it from its attachment site.

Trade-offs: Less invasive procedure with faster recovery. However, recurrence rates can be significant if the base is not completely removed.

Ventral bulla osteotomy

Surgical approach to the middle ear allowing thorough removal of polyp tissue from its origin.

Trade-offs: More invasive procedure with longer recovery but lower recurrence rates. May cause temporary or permanent Horner's syndrome.

Total ear canal ablation with bulla osteotomy

Considered when extensive ear canal disease is present alongside the polyp.

Trade-offs: Major surgery resulting in hearing loss on that side. Reserved for severe or recurrent cases.

Postoperative corticosteroids

Short courses of steroids after traction removal may reduce recurrence in some protocols.

Trade-offs: Evidence for benefit is mixed. May help reduce inflammation at the removal site.

Common misconceptions

Misconception:

"Polyps are cancerous growths that spread."

Reality:

Nasopharyngeal polyps are benign inflammatory growths. They do not metastasise or spread like cancer, though they can regrow locally if incompletely removed.

Misconception:

"Antibiotics can treat polyps."

Reality:

Antibiotics may help manage secondary infections but cannot shrink or eliminate polyps. Surgical removal is the definitive treatment.

Misconception:

"All snoring or noisy breathing in cats indicates polyps."

Reality:

While polyps are one cause of upper airway noise, many other conditions can cause similar signs. Investigation is needed to determine the cause.

Understanding that noisy breathing or ear problems in young cats may warrant investigation can help with timely recognition. Learning about the typical presentation of polyps in cats provides useful context. Keeping track of respiratory sounds, sneezing frequency, and any ear-related behaviours may provide helpful information to share with your veterinary team.

Last reviewed: 24 April 2026 · Dr Alastair Greenway MRCVS