Nasal Polyps
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Basics
- Chronic benign inflammatory lesion of nasal mucosa
- Arise from near the ethmoid sinus but can infrequently arise from maxillary sinus mucosa
Description
- Appearance of edematous pedunculated mass in the nasal cavity or within the paranasal sinus
- Often causes symptoms of blockage, discharge, or loss of smell
- Most commonly bilateral; if unilateral, malignancy should be on differential.
Epidemiology
Incidence
- Typical age at diagnosis ranges from 40 to 60 years.
- Increases with age to a peak in the sixth decade
Prevalence
- ~4% in general population
- Much rarer in children: ~0.1% and associated with cystic fibrosis
- Asthma is present in up to 65% of patients.
Etiology and Pathophysiology
- Separate T helper 1- and T helper 2-driven pathways
- White patients who have chronic rhinosinusitis with nasal polyps: Majority have type 2 pattern of inflammation.
- Characterized by eosinophilia and elevated levels of interleukin-4, interleukin-5, and interleukin-13 cytokines
Genetics
Risk Factors
General Prevention
Use of intranasal corticosteroids after polyp removal surgery has shown effectiveness against recurrence.
Commonly Associated Conditions
- Asthma
- Bronchiectasis
- Aspirin hypersensitivity
- Allergic rhinitis
- Chronic sinusitis
- Allergic fungal sinusitis
- Cystic fibrosis (pediatric patients)
- Primary ciliary dyskinesia (Kartagener syndrome)
- Laryngopharyngeal reflux
- Sleep apnea
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
- Chronic benign inflammatory lesion of nasal mucosa
- Arise from near the ethmoid sinus but can infrequently arise from maxillary sinus mucosa
Description
- Appearance of edematous pedunculated mass in the nasal cavity or within the paranasal sinus
- Often causes symptoms of blockage, discharge, or loss of smell
- Most commonly bilateral; if unilateral, malignancy should be on differential.
Epidemiology
Incidence
- Typical age at diagnosis ranges from 40 to 60 years.
- Increases with age to a peak in the sixth decade
Prevalence
- ~4% in general population
- Much rarer in children: ~0.1% and associated with cystic fibrosis
- Asthma is present in up to 65% of patients.
Etiology and Pathophysiology
- Separate T helper 1- and T helper 2-driven pathways
- White patients who have chronic rhinosinusitis with nasal polyps: Majority have type 2 pattern of inflammation.
- Characterized by eosinophilia and elevated levels of interleukin-4, interleukin-5, and interleukin-13 cytokines
Genetics
Risk Factors
General Prevention
Use of intranasal corticosteroids after polyp removal surgery has shown effectiveness against recurrence.
Commonly Associated Conditions
- Asthma
- Bronchiectasis
- Aspirin hypersensitivity
- Allergic rhinitis
- Chronic sinusitis
- Allergic fungal sinusitis
- Cystic fibrosis (pediatric patients)
- Primary ciliary dyskinesia (Kartagener syndrome)
- Laryngopharyngeal reflux
- Sleep apnea
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