What are Causes of Nasal Polyp Formation ???

The prime histological feature of nasal polyps is a massive infiltration of eosinophils and eosinophil is considered to be present in 86% of all nasal polyps. Recent studies have suggested that the airway epithelium plays an important role in the patho genesis of inflammatory airway diseases. This suggests that factors leading to the development of nasal polyposis include pathophysiological changesin electrolyte and water transport in the surface epithelium.

 Furthermore, it has been suggested that a fungaletiology may underlie severe nasal polyposis, although this notion is still controversial. As apossible mechanism by which fungi act on therespiratory epithelium, it has been suggested that fungi produce  proteases that bind toprotease-activated receptors; this binding would activate intracellular  signalling path ways thatwould give rise to multiple responses, including cytokine production and disruption  of  tight junctions

Glucocorticoids are known to be effective in the treatment of nasal polyps. Another recent study has claimed that the clinical efficacy of glucocorticoids on nasal polyps may be due to the induction of apoptosis in both eosinophils and T lymphocytesthat infiltrate nasal polyps, and to down-regulationof epithelial GM-CSF production, which prolongseosinophil  survival. Steroids alsosignificantly decreased all cytokine/chemokine levels, but theirimpact on Th2 chemokines was of a much greatermagnitude.This accumulated evidence supportsan important role for eosinophils in nasal polyps

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New Treatment for Nasal Polyps

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Intranasal lysine-aspirin is a potential alternative to oral desensitization in patients with aspirin-sensitive nasal polyposis . Uncritical trials have suggested its effectiveness. Recent study have undertaken the first scientifically controlled trial. Randomized, double blind, placebo controlled, crossover trial using low dose (8mgs) intranasal lysine-aspirin (LAS) in polyp patients who reacted positively to nasal challenge with lysine aspirin. Nasal polyp size was measured using acoustic rhinometry. Patients maintained a daily diary of nasal and chest scores, nasal inspiratory peak flow (NIPF) and peak expiratory flow rate (PEFR). No other polyp therapy was permitted. 10  patients completed both phases. Multivariate analysis did not show any significant difference between the placebo or LAS phase. Volume and minimal cross sectional area changes were similar in both phases (p=.587, p=.774). Diary scores were similar (nasal score, p=.82; chest score p=.82; NIPF, p=.44; PEFR, p=.95...
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What are Nasal Polyps Symptoms and Treatment ?

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The European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2012) defines Nasal Polyps as an inflammatory disease of the nasal and the paranasal sinus mucosa characterized by 2 or more symptoms, one of which is nasal blockage/obstruction/ congestion or nasal discharge (anterior/posterior nasal drip). Other potential symptoms include facial pain/pressure and reduction or loss of smell. In addition to 2 or more symptoms, at least one of the 2 objective findings is required. These include: (1) endoscopic evidence of nasal polyps or mucopurulent discharge or edema/mucosal obstruction primarily in the middle meatus; (2) computed tomographic (CT) radiographic imaging demonstra¬tion of mucosal changes (ie, edema) in the OMC or sinuses. The diagnosis of Nasal Polyps is established if these symptoms and objective findings persist longer than 12 consecutive weeks without a symptom-free period. Nasal Polyps is a heterogeneous disease with different underlying pathophysiologic mechanisms....
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Sinus Surgery Nasal Polyps - Good or Bad ?

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Nasal polyps significantly affects patient quality of life. Medical and surgical treatments aim to clinically manage the condition.Nasal polyps treatment aims to attain clinical control of the disease, which is defined as the elimination or mitigation of patient symptoms to a point where subjects are no longer bothered by the disease, possibly in combination with a healthy or quasi healthy mucosa requiring only the administration of topical medication . Endoscopic sinus surgery significantly improved the quality of life of patients with Nasal polypsPatients had acceptable levels of medical management of their condition and few required re-operation within two years of surgery.  Despite the improvements in symptoms and quality of  life  provided by sinus surgery,  it fails to act on  certain aspects of the complex pathophysiology of chronic rhinosinusitis and cannot cure patients alone. Long term follow-up is of the essence, but proper management can be challengi...
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