abstract

NP are common,affecting up to 4% of the

population. Their etiology remains unclear, but
they are known to have associations with allergy,
asthma, infection, cystic fibrosis and aspirin
sensitivity.
They present with nasal obstruction, anosmia,
rhinorhoea, post nasal drip, and less commonly
facial pain. Management of NP involves a
combination of medical therapy and surgery.
 1. Introduction
Nasal polyps (NP) are benign lesions arising
from the mucosa of the nasal sinuses
(commonly at the outfl ow tract of one or
more of the sinuses) or from the mucosa of
the nasal cavity
This paper aims to summarize current trends in
all aspects of management of NP.
 Clinical features
Nasal obstruction
Rhinorrhea and postnasal drip
Anosmia and hiposmia
Anterior and posterior rhinoscopy reveals
single or multiple pale, grey polypoid masses
arising most frequently from the middle
meatus and prolapsing into the nasal cavity
 They consist of loose connective tissue,
edema,infl ammatory cells, and some capillaries
and glands
The histological appearance of NP is
characterized by ciliated columnar epithelium,
thickening of the basement membrane, a loose
avascular edematous stroma and an infi ltrate of
plasma cells and eosinophils
Eosinophils are found in 85% of NP with the
remaining cells being predominantly neutrophils
Patophysiology of Nasal Polyp
Accumulation of
Inflamation Concha hipertrophy
debris and WBC

Changes in ion Resulting injury on

Friction with the air
tranport mucus

Increase Natrium
influx fron
extracellular to
intracellular
 Natrium
Edema Respon injury
retention

Sometimes the
Re-epitelization
Mass re-epitelization
occurs
wasnt perfect

Obstruction air
flow, hiposmia,
anosmia, snoring
 Treatment of Nasal Polip

Management : Step : Purpose :

Combination Medical Reduce the

of medical treatment is size of the NP
and surgical the primary Relief of nasal
treatment care before obstruction
surgical Improve the
treatmen sinus
drainage
 Medical Treatment
Corticostreroid 50 mg prednisolon daily for 14 days with
topical and placebo . Reduce nasal symptoms and
sistemic endoscopic findings. (Hissaria, 2006)

Saline nasal Improve nasal mucocilliary clearence

douching measured (Talbot, 1997)

For rhinisinusitis and sinusitis

Antibiotics Not effective to NP (Batemen, 2003)
 Adjuvant to antibiotics in acute sinusitis to
Mucolytics reduce viscocity of sinus secretion, also in
NP.

Reduce sneezing, rhinorrhea and

obstruction .
Antihistamin Reduce in polip size at 3 mounths (Haye,
1998)

Topical Effective
Capsaicin Side effect : Burning of the nasal mucosa.
 Surgical Treatment
Endoscopy Sinus Between ESS and
Polypectomy
Surgery Polypectomy

Polip Recurence Polip Recurence ESS is now the

28% 35 % mainstay of
treatmen for NP.
Reduce
obstruction in soft
tissue.
Remove NP
Compilcations :
loss of visions,
damage to the
carotid artery ,etc.
Thanks