nasal polyps

what are nasal polyps?

benign swellings of mucosal lining of paranasal sinuses

how do nasal polyps form?

clump of epithelial cells undergoes hyperplasia

what do the polyps consists of?

- loose connective tissue

- oedema

- inflammatory cells

- glandular cells

- capillaries

which is the most abundant inflammatory cell in nasal polyps?

eosinophils

which is the most common paranasal sinus for polyps to arise from?

ethmoid sinus

what is the age and sex of a typical pt presenting with nasal polyps?

male >40 y/o

what is the triad associated with nasal polyps?

Samter's triad

what is Samter's triad?

- atopy

- aspirin sensitivity

- nasal polyps

what are the features of the conditions in samter's triad?

aspirin and NSAID-exacerbated respiratory disease

what are the other associated conditions with nasal polyps?

- CF

- kartagener's syndrome

- churg-strauss syndrome

what are the clinical features of nasal polyps?

- watery rhinorrhoea (runny nose)

- purulent postnasal drip

- nasal obstruction

- change in voice

- anosmia - nose blind

- sinusitis

- headaches

- mouth-breathing

- snoring

- cyanosis (in paeds)

are nasal polyps tender?

no

can nasal polyps be mobile?

yes

what are the investigations for nasal polyps?

- anterior rhinoscopy

- nasal endoscopy

what is the management of nasal polyps?

- intranasal corticosteroid - fluticasone

- surgical polypectomy (post-op doxycycline + nasal saline irrigation)

what are the complications of treatment?

- damage to optic nerve

- CSF leak

- advise to not blow nose - bleeding

when should someone be referred to ENT with nasal polyps?

- unilateral

- bleeding