Nasal polyps are mucosal hyperplasia filled with inflammatory substances that may form in the nasal cavity or paranasal sinuses. The average age of onset of nasal polyps is 42 years old, less common under 20 years old, and more men than women1. Because rhinosinusitis is often accompanied by nasal polyps, it is difficult to distinguish them absolutely. Clinically, nasal polyps are considered as a subgroup of rhinosinusitis 2.
The occurrence of nasal polyps is influenced by both genetic and environmental factors 1. In adults, nasal polyps are frequently associated with chronic rhinosinusitis, asthma, and 、spirin、 sensitivity in the syndrome of aspirin-exacerbated respiratory disease (AERD). Some patients have concomitant allergic rhinitis or allergic fungal rhinosinusitis. In children, nasal polyps are most commonly associated with cystic fibrosis.
Small polyps often do not cause any symptoms. Large polyps or having more than one polyp can cause:
●Stuffiness or a blocked feeling in the nose
●Feelings of pressure or fullness in the face
Surgery can offer temporary relief, although polyps tend to recur within a few months to years following this intervention alone. Continued medical management of the underlying etiology is therefore mandatory after surgery, including intranasal glucocorticoids, allergen immunotherapy (if applicable), antileukotriene therapy, and daily lavage of the sinuses. In patients with AERD, aspirin desensitization followed by long-term daily therapy may be an additional therapeutic option.
1. Wytske J. Fokkens, Valerie J. Lund, Joachim Mullol, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012[J]. Rhinology, 2012, Suppl.23(Suppl.23): 1-298.
2. Dykewicz MS. 7. Rhinitis and sinusitis. J Allergy Clin Immunol [J]. 2003, 111(2 Suppl): S520-9.