Nasal polyp
Encyclopedia
Nasal polyps are polypoidal
masses arising mainly from the mucous membrane
s of the nose
and paranasal sinus
es. They are overgrowths of the mucosa that frequently accompany allergic rhinitis
. They are freely movable and nontender.
es and are the much less common, ethmoidal polyps arise from the ethmoidal sinuses. Antrochoanal polyps are usually single and unilateral whereas ethmoidal polyps are multiple and bilateral.
Symptoms of polyps include nasal block, sinusitis
, anosmia
(loss of smell), and secondary infection
leading to headache
. Despite removal by surgery, nasal polyps are found to reoccur in about 70% of cases. Sinus surgery requires great amount of precision as this involves risk of damage to orbit matter.
The tendency to manifest multiple polyps is referred to as “polyposis”.
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:
Exposure to some forms of chromium
can cause nasal polyps and associated diseases.
They are also linked to salicylate sensitivity
.
s 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.
Polyp (medicine)
A polyp is an abnormal growth of tissue projecting from a mucous membrane. If it is attached to the surface by a narrow elongated stalk, it is said to be pedunculated. If no stalk is present, it is said to be sessile. Polyps are commonly found in the colon, stomach, nose, sinus, urinary bladder...
masses arising mainly from the mucous membrane
Mucous membrane
The mucous membranes are linings of mostly endodermal origin, covered in epithelium, which are involved in absorption and secretion. They line cavities that are exposed to the external environment and internal organs...
s of the nose
Human nose
The visible part of the human nose is the protruding part of the face that bears the nostrils. The shape of the nose is determined by the ethmoid bone and the nasal septum, which consists mostly of cartilage and which separates the nostrils...
and paranasal sinus
Paranasal sinus
Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity , above and between the eyes , and behind the ethmoids...
es. They are overgrowths of the mucosa that frequently accompany allergic rhinitis
Allergic rhinitis
Allergic rhinitis, also known as pollenosis or hay fever, is an allergic inflammation of the nasal airways.It occurs when an allergen, such as pollen, dust or animal dander is inhaled by an individual with a sensitized immune system...
. They are freely movable and nontender.
Description
Nasal polyps are usually classified into antrochoanal polyps and ethmoidal polyps. Antrochoanal polyps arise from the maxillary sinusMaxillary sinus
The pyramid shaped maxillary sinus is the largest of the paranasal sinuses, and drains into the nose. It is present at birth as rudimentary air cells, and develops throughout childhood.-General characteristics:...
es and are the much less common, ethmoidal polyps arise from the ethmoidal sinuses. Antrochoanal polyps are usually single and unilateral whereas ethmoidal polyps are multiple and bilateral.
Symptoms of polyps include nasal block, sinusitis
Sinusitis
Sinusitis is inflammation of the paranasal sinuses, which may be due to infection, allergy, or autoimmune issues. Most cases are due to a viral infection and resolve over the course of 10 days...
, anosmia
Anosmia
Anosmia is a lack of functioning olfaction, or in other words, an inability to perceive odors. Anosmia may be either temporary or permanent. A related term, hyposmia, refers to a decreased ability to smell, while hyperosmia refers to an increased ability to smell. Some people may be anosmic for one...
(loss of smell), and secondary infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
leading to headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...
. Despite removal by surgery, nasal polyps are found to reoccur in about 70% of cases. Sinus surgery requires great amount of precision as this involves risk of damage to orbit matter.
The tendency to manifest multiple polyps is referred to as “polyposis”.
Types
There are 2 major types of nasal polyps.- 1. Antrochoanal
- a. Single, Unilateral
- b. Can originate from maxillary sinusMaxillary sinusThe pyramid shaped maxillary sinus is the largest of the paranasal sinuses, and drains into the nose. It is present at birth as rudimentary air cells, and develops throughout childhood.-General characteristics:...
. - c. Usually found in children.
- a. Single, Unilateral
- 2. Ethmoidal
- a. Bilateral
- b. Usually found in adults.
- a. Bilateral
Causes
The pathogenesisPathogenesis
The pathogenesis of a disease is the mechanism by which the disease is caused. The term can also be used to describe the origin and development of the disease and whether it is acute, chronic or recurrent...
of nasal polyps is unknown. Nasal polyps are most commonly thought to be caused by allergy and rarely by cystic fibrosis
Cystic fibrosis
Cystic fibrosis is a recessive genetic disease affecting most critically the lungs, and also the pancreas, liver, and intestine...
although a significant number are associated with non-allergic adult asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
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
- AsthmaAsthmaAsthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
- Aspirin intolerance
- Cystic fibrosisCystic fibrosisCystic fibrosis is a recessive genetic disease affecting most critically the lungs, and also the pancreas, liver, and intestine...
- Kartagener's syndrome
- Young's syndrome
- Churg-strauss syndromeChurg-Strauss syndromeChurg–Strauss syndrome is a medium and small vessel autoimmune vasculitis, leading to necrosis. It involves mainly the blood vessels of the lungs , gastrointestinal system, and peripheral nerves, but also affects the heart, skin and kidneys. It is a rare disease that is non-inheritable and...
- Nasal mastocytosisMastocytosisMastocytosis is a group of rare disorders of both children and adults caused by the presence of too many mast cells and CD34+ mast cell precursors in a person's body.- Classification :Mastocytosis can occur in a variety of forms:...
Exposure to some forms of chromium
Chromium
Chromium is a chemical element which has the symbol Cr and atomic number 24. It is the first element in Group 6. It is a steely-gray, lustrous, hard metal that takes a high polish and has a high melting point. It is also odorless, tasteless, and malleable...
can cause nasal polyps and associated diseases.
They are also linked to salicylate sensitivity
Salicylate sensitivity
Salicylate sensitivity, also known as salicylate intolerance, is any adverse effect that occurs when a normal amount of salicylate is introduced into a person's body...
.
Treatments
Nasal polyps are most often treated with steroidSteroid
A steroid is a type of organic compound that contains a characteristic arrangement of four cycloalkane rings that are joined to each other. Examples of steroids include the dietary fat cholesterol, the sex hormones estradiol and testosterone, and the anti-inflammatory drug dexamethasone.The core...
s 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 chloride
Sodium chloride, also known as salt, common salt, table salt or halite, is an inorganic compound with the formula NaCl. Sodium chloride is the salt most responsible for the salinity of the ocean and of the extracellular fluid of many multicellular organisms...
& sodium bicarbonate
Sodium bicarbonate
Sodium bicarbonate or sodium hydrogen carbonate is the chemical compound with the formula Na HCO3. Sodium bicarbonate is a white solid that is crystalline but often appears as a fine powder. It has a slightly salty, alkaline taste resembling that of washing soda . The natural mineral form is...
) can be very helpful to clear the sinuses
Paranasal sinus
Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity , above and between the eyes , and behind the ethmoids...
. 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
Mometasone furoate
Mometasone furoate is a glucocorticosteroid used topically to reduce inflammation of the skin or in the airways.-Uses, administration, and pharmacodynamics:...
, commonly available as a nasal spray for treating common allergy symptoms, has been indicated in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
by the FDA
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
for the treatment of nasal polyps since December 2005.
External links
- Nasal Polyps emedicine.com
- Nasal polyps: Signs and symptoms mayoclinic.com