Sinonasal polyps.Sinonasal polyps are caused by a multitude of factors. The most common causes are repeated bouts of sinusitis, allergy, vasomotor rhinitis, infectious rhinosinusitis, and asthma. Less often, they occur in association with diabetes mellitus, cystic fibrosis, and aspirin intolerance. They form as a result of an influx of fluids into the schneiderian mucosal lamina propria. Occasionally, antral (maxillary) polyps expand and prolapse prolapse Protrusion of an internal organ out of its normal place, usually of the rectum or uterus outside the body when supporting muscles weaken. The membrane lining the rectum can push out through the anus, most often in old people with constipation who strain during through sinus ostia Ostia (ŏs`tēə), ancient city of Italy, at the mouth of the Tiber. It was founded (4th cent. B.C.) as a protection for Rome, then developed (from the 1st cent. B.C.) as a Roman port, rivaling Puteoli. to present intranasally or in the nasopharynx (antrochoanal polyps). Sinonasal polyps have no predisposition to age or sex. Polyps are uncommon in children, but when they do occur, as many as 30% are associated with cystic fibrosis. Patients with sinonasal polyps present with rhinorrhea, stuffiness, nasal discharge, headaches, sinusitis, and other nonspecific symptoms referable to the sinonasal tract. Radiographic radiographic (rā´dēōgraf´ik), adj relating to the process of radiography, the finished product, or its use. studies may show a solitary mass or multiple expansile ex·pan·sile adj. Of, relating to, or capable of expansion. Adj. 1. expansile - (of gases) capable of expansion expandable, expandible, expansible masses within the nasal cavity and/or paranasal sinuses, frequently associated with mucus retention or thickened mucosa. Sinonasal polyps are usually smooth, glistening, translucent, and gray to pink. Classic sinonasal polyps are polypoid structures with an edematous e·dem·a·tous adj. Marked by edema. to fibrous stroma stroma /stro·ma/ (stro´mah) pl. stro´mata [Gr.] the matrix or supporting tissue of an organ.stro´malstromat´ic stro·ma n. pl. stro·ma·ta 1. (figure 1). Pseudoangiomatous (lymphangiomatous) polyps contain proliferating thin-walled vessels in a loose edematous to myxoid myxoid /myx·oid/ (mik´soid) mucoid. myx·oid adj. Containing or resembling mucus; mucoid. myxoid resembling mucus. myxoid adjective 1. matrix (figure 2). The surface is usually intact, although squamous metaplasia and ulceration can develop. Polyps contain a moderate degree of chronic inflammation within the lamina propria (figure 3). Mucoserous glands are present. If the polyps are related to allergies or asthma, a thickened basement membrane and a prominent eosinophilic eosinophilic /eo·sin·o·phil·ic/ (-fil´ik) 1. readily stainable with eosin. 2. pertaining to eosinophils. 3. pertaining to or characterized by eosinophilia. infiltrate may be seen. Polyps of all types may undergo infarction, organization, or secondary infection. Polyps may coexist with other sinonasal tract disorders, which should be carefully excluded. [FIGURES 1-3 OMITTED] Removal of the underlying etiologic agent, if known, results in a significant reduction in morbidity. Polyps are usually amenable to conservative endoscopic removal and improved sinus ventilation. Suggested reading Gysin C, Alothman GA, Papsin BC. Sinonasal disease in cystic fibrosis: Clinical characteristics, diagnosis, and management. Pediatr Pulmonol 2000;30(6):481-9. Passali D, Bellussi L, Hassan HA, et al. Consensus Conference on Nasal Polyposis. Acta Otorhinolaryngol Ital 2004;24(2 supp177):3-61. |
|
||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion