CONDITION
Nasopharyngeal Polyps
A nasopharyngeal polyp is a benign growth that arises from the lining of the middle ear or Eustachian tube and grows into the back of the nasal passages (the nasopharynx) or the ear canal, most often in young cats and rarely in dogs. These growths are not cancerous, but they can occupy space in narrow airways and interfere with normal breathing, swallowing, or hearing depending on where they sit and how large they become. Owners often notice noisy breathing, snoring sounds that seem new, discharge from one or both nostrils, difficulty swallowing, or a head tilt if the inner ear becomes involved. The signs can develop gradually and may be mistaken for a persistent upper respiratory infection, particularly when discharge is present. In some cases, a fleshy mass may be visible at the back of the throat. This page explores what these signs can indicate, the structures involved and how polyps form, the diagnostic steps used to locate and characterise the growth, and the approaches available for removal. The goal is to help you understand what may be happening and what the investigative and management pathway typically looks like.
Why this matters now
Nasopharyngeal polyps are most commonly diagnosed in young cats, often under 2 years of age, though presentation can range from kittens a few months old to older cats.
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 normally breathe through the nose, so breathing with the mouth open is not normal in a resting cat. It shows that air is no longer getting past the polyp, and how much reserve the cat has left cannot be judged at home. Laboured breathing, with visible effort at the chest and belly, carries the same weight.
Ear discharge
Brown or purulent discharge from the ear canal suggests extension of the polyp into the external ear.
Head tilt
If inflammation spreads from the middle ear to the inner ear, balance signs such as a head tilt, unsteadiness and flicking eye movements (nystagmus) 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
Otoscopic examination
CT or MRI imaging
Histopathology
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, regrowth after traction is reported in roughly 13 to 57% of cats across published case series, and is more likely when the polyp extends into the ear canal than when it sits only in the nasopharynx. Horner's syndrome (a drooping upper eyelid, small pupil and raised third eyelid) is a recognised complication and is usually temporary.
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 (reported as 0 to 33%). Horner's syndrome is common afterwards, reported in 57 to 81% of cats, and is usually temporary but can be permanent.
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: In one review of 37 cats, none of the cats given a steroid after traction had a recurrence, but the evidence comes from small retrospective case series. May help reduce inflammation at the removal site.
Common misconceptions
"Polyps are cancerous growths that spread."
Nasopharyngeal polyps are benign inflammatory growths. They do not metastasise or spread like cancer, though they can regrow locally if incompletely removed.
"Antibiotics can treat polyps."
Antibiotics may help manage secondary infections but cannot shrink or eliminate polyps. Removing the polyp is the treatment.
"All snoring or noisy breathing in cats indicates polyps."
While polyps are one cause of upper airway noise, many other conditions can cause similar signs. Investigation is needed to determine the cause.
Related conditions
Otitis Media
Nasopharyngeal polyps in cats arise from the lining of the middle ear or Eustachian tube and extend into the nasopharynx, the ear canal or both, and otitis media may be present alongside the polyp or develop as a consequence of the same underlying inflammation. The two conditions can share clinical signs such as ear discharge and head shaking, and a head tilt can develop in either if inflammation spreads to the inner ear.
Chronic Upper Respiratory Disease in Cats
Chronic upper respiratory signs in cats (such as nasal discharge, sneezing and noisy breathing) can be caused by a nasopharyngeal polyp, and the two may be difficult to distinguish without direct visualisation or imaging. Polyps are often considered during investigation of persistent or recurrent upper respiratory signs that do not resolve with treatment aimed at infection alone.
Laryngeal Paralysis
Both nasopharyngeal polyps and laryngeal paralysis can cause noisy breathing and respiratory difficulty, though the anatomical site and underlying mechanism differ. In cases where a mass effect in the pharynx is suspected, imaging and examination may be needed to distinguish between a space-occupying polyp and a larynx that does not open normally during breathing.
Brachycephalic Obstructive Airway Syndrome (BOAS) in Dogs
Dogs with brachycephalic obstructive airway syndrome and cats with nasopharyngeal polyps can both present with stertor, difficulty breathing, and exercise intolerance due to narrowing of the upper airway. While the anatomical causes differ, both conditions involve obstruction in the region where air enters the respiratory tract, and clinical signs may overlap in presentation.
Aspergillosis (Nasal)
Nasal aspergillosis and nasopharyngeal polyps can both cause unilateral or bilateral nasal discharge, sneezing, and nasal obstruction, and may need to be distinguished during diagnostic investigation. Imaging and direct examination of the nasal passages and nasopharynx help differentiate between fungal colonisation with tissue destruction and a discrete benign mass.
Understanding that noisy breathing or ear problems in young cats may warrant investigation can help with timely recognition. Keeping track of respiratory sounds, sneezing frequency, and any ear-related behaviours may provide helpful information for the veterinary team.
Last reviewed: 10 October 2026 · Dr Alastair Greenway MRCVS