Nasal polyps can be described under following headings
D. Ethmoidal Polyp
Definition – Etiology – Pathogenesis -Pathology – Site of origin – Symptoms – Signs – Differential Diagnosis – Staging of mucosal polyp – Investigations – Treatment – Complications of surgery
E. Antrocoanal Polyp – Definition -Etiology-Pathology -Symptoms -Signs -Differential diagnosis -Treatment
F. Prevention of Recurrence of Nasal Polyps
G. Complications of Nasal Polyps
H. Important Points to Remember in a Case of Nasal Polyps
Nasal polyps are non-neoplastic masses of edematous nasal or sinus mucosa
Incidence in general population is unknown possibly between 1 % -2 % . There is higher incidence in asthmatics (20 -30 %) and even higher (49 %) in those asthmatics hypersensitive to aspirin. It is most common in middle aged men.
Nasal polyps are classified into 2 main categories.
There is edematous hypertrophy of submucosa with loose fibrous stroma.
Polyps are RED FLAGS indicating the presence of chronic inflammatory: chronic sinusitis (longstanding bacterial infection of facial sinuses ) is one explanation; as is allergy (eg allergy to pollen, dust mites, mold spore, cat dander etc).
Other possible causes are:
Nasal mucosa becomes edematous due to collection of extracellular fluid causing polypoidal change. Polypi which are sessile in the beginning become pedunculated due to gravity and excessive sneezing which is associated with allergy.
Due to metaplasia ,the normal ciliated lining is converted into squamous type over the polyp side(which is exposed to atmospheric air ).There is also infiltration with eosinophil and round cells.
Multiple nasal polypi arises from the lateral wall of nose usually from middle meatus. Common sites are:
Allergic nasal polypi almost never arises from the septum or floor of nose.