Nasal Polyps
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 old.
- Increases with age to a peak in the 6th 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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Citation
Domino, Frank J., et al., editors. "Nasal Polyps." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688446/all/Nasal_Polyps.
Nasal Polyps. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688446/all/Nasal_Polyps. Accessed December 8, 2023.
Nasal Polyps. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688446/all/Nasal_Polyps
Nasal Polyps [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 December 08]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688446/all/Nasal_Polyps.
* Article titles in AMA citation format should be in sentence-case
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ED - Stephens,Mark B,
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