Summary
Definition
Nasal polyps (NP) are swellings of the mucosal lining of the paranasal sinuses and are considered to represent a subgroup of chronic rhinosinusitis. They are made up of a mixture of loose connective tissue, oedema, inflammatory cells (mostly eosinophils), glandular cells, and capillaries. They are covered with varying types of epithelium, mostly respiratory pseudostratified epithelium with ciliated cells and goblet cells. They are associated with nasal congestion and blockage, rhinorrhoea, posterior nasal drip, and decreased sense of smell.
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Grade 3 nasal polyps
From the collection of Dr Richard Hewitt
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History and exam
Key diagnostic factors
- chronic rhinosinusitis
- nasal obstruction
- nasal discharge
- facial pain/pressure
- direct visualisation
Other diagnostic factors
- reduced sense of smell
- cough
- sore throat
- dysphonia
- malaise
- drowsiness
Risk factors
- asthma
- aspirin sensitivity
- Churg-Strauss syndrome
- allergic fungal sinusitis
- genetic predisposition
- cigarette smoking
Diagnostic investigations
Investigations to consider
- CT head
- biopsy
- nasal smear and culture
- FBC with differential
- ANCA
- ESR
- skin-prick tests
- serum total and specific IgE
- nasal airway assessment
- aspirin challenge
Treatment algorithm
Contributors
Authors VIEW ALL
Consultant Rhinologist
Charing Cross Hospital
Honorary Senior Lecturer
Imperial College
London
UK
Disclosures
HAS declares that he has no competing interests.
Consultant ENT Surgeon
Imperial College NHS Trust
London
UK
Disclosures
RK declares that she has no competing interests.
Dr Hesham A. Saleh and Dr Romana Kuchai would like to gratefully acknowledge Dr Richard J.D. Hewitt, the previous contributor to this monograph.
Disclosures
RJDH declares that he has no competing interests.
Peer reviewers VIEW ALL
Associate Professor
Director of Rhinology and Endoscopic Sinus and Skull Base Surgery
Department of Otolaryngology and Head & Neck Surgery
Eastern Virginia Medical School
Norfolk
VA
Disclosures
JKH declares that he has no competing interests.
Consultant Surgeon
Department of Otolaryngology Head and Neck Surgery
Aberdeen Royal Infirmary
Aberdeen
UK
Disclosures
SM declares that she has no competing interests.
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