nasal inflammatory polyp

Topographical subtypes

There are 2 major types of nasal polyps.

 Antrochoanal

• Single, Unilateral
• Can originate from maxillary sinus.
• Usually found in children.

 Ethmoidal

• Bilateral
• Usually found in adults.

Types

 nasal allergic polyp

Etiology

 Causes

The pathogenesis of nasal polyps is unknown. Nasal polyps are most commonly thought to be caused by allergy and rarely by cystic fibrosis although a significant number are associated with non-allergic adult asthma or no respiratory or allergic trigger that can be demonstrated.

These polyps have no relationship with colonic or uterine polyps. Irregular unilateral polyps particularly associated with pain or bleeding will require urgent investigation as they may represent an intranasal tumour.

There are various diseases associated with polyp formation:

 chronic rhinosinusitis
 asthma (nasal allergic polyp)
 aspirin intolerance
 cystic fibrosis
 Kartagener syndrome
 Young syndrome
 Churg-strauss syndrome
 nasal mastocytosis

Exposure to some forms of chromium can cause nasal polyps and associated diseases.

They are also linked to salicylate sensitivity.

Treatments

Nasal polyps are most often treated with steroids or topical, but can also be treated with surgical methods.

Pre-post surgery, sinus rinses with a warm water (240 ml / 8 oz) mixed with a small amount (teaspoon) of salts (sodium chloride & sodium bicarbonate) can be very helpful to clear the sinuses. This method can be also used as a preventative measure to discourage the polyps from growing back and should be used in combination with a nasal steroid.

The removal of nasal polyps via surgery lasts approximately 45 minutes to 1 hour. The surgery can be done under general or local anaesthesia, and the polyps are removed using endoscopic surgery. Recovery from this type of surgery is anywhere from 1 to 3 weeks.

Mometasone furoate, commonly available as a nasal spray for treating common allergy symptoms, has been indicated in the United States by the FDA for the treatment of nasal polyps since December 2005.

Links

 eMedicine - Nasal Polyps : Article by John E McClay, MD