CONDITION
Nasopharyngeal Polyps
A nasopharyngeal polyp is a benign growth that develops in the soft tissue at the back of the nasal passages or in the middle ear, most often in young cats and occasionally 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 polyp affects the ear. 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. 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
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, 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
"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. Surgical removal is the definitive 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 can extend from the middle ear into the nasopharynx, or arise in the nasopharynx and grow towards the ear, 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 head tilt, ear discharge, and difficulty swallowing when both structures are involved.
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 dysfunction of the laryngeal cartilages.
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. 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