Nasal polyps J33.-

Nasal polyps are defined as polyätiological, benign tissue growths of the nasal mucosa. They develop in the paranasal sinuses and grow from there into the main nasal cavity. Especially the ethmoid sinuses and the sphenoidal sinus are predestined for the formation of polyps.

Nasal polyps are observed in the following clinical constellations:

• Bilateral nasal polyps in chronic infections or allergic diathesis
• Bilateral nasal polyps in acetylsalicylic acid intolerance (see also rhinitis pseudoallergic)
• Unilateral choanal polyp (usually small polyp in chronic infectious sinusitis)
• Bilateral eosinophilic polyposis
• Nasal polyps, on both sides in cystic fibrosis or ciliary dyskinesia syndrome (occurrence of polyps already in childhood)
• Nasal polyps with paranasal sinus mycosis

About 4% of the German population is affected; m:w=2:1.

Risk factors are persistent inflammation of the mucous membranes (e.g. due to allergic reactions or chronic infections). Genetic disposition. Pile up in connection with bronchial asthma and an intolerance to painkillers)

Mainly in adulthood after the age of 30. In childhood mainly in cystic fibrosis (mucoviscidosis) and even less frequently in ciliary dyskinesia.

Flat or stalked, soft, usually glassy yellowish or greyish-pink growths, a few millimetres to several centimetres in size, growing into the nasal cavity. If they are large enough, they can completely block the nasal cavity.

Depending on their size, the patient suffers mainly from obstructed nasal breathing and its consequences (incorrect cleaning, humidification and heating of the air breathed). Inevitably, the patient prefers to breathe through the mouth. This allows pathogens to enter the airways unhindered and cause irritation and inflammation of the throat (pharyngitis), larynx (laryngitis) or bronchial tubes (bronchitis).

Pale grey, oedematous, sometimes fibrous, stalked protuberances from the middle nasal passage, the ethmoid bone and from the middle nasal concha. They can be divided histologically into 4 groups. The "edematous eosinophilic polyp" is by far the most common type with a frequency of 65-90%.

Endoscopy and computer tomography

Conservative therapy with topical and systemic corticosteroids. In case of failure endoscopic surgical treatment with different techniques.

Nasal polyps are to be distinguished from the enlarged pharyngeal tonsils, colloquially called "polyps". These are lymphatic tissue (adenoid).

1. Grevers G et al (1999) Polyposis nasi-effective treatment without operation? Broad etiological spectrum, individual therapy. MMW Fortschr Med 141:26-31.
2. Grevers G (2010) Polyposis nasi- conservative measures versus surgical treatment. MMW Progress Med 152:36-38.
3. Koenecke M et al (2018) Subtyping of polyposis nasi: phenotypes, endotypes and comorbidities. Allergo J00 Int 27: 65-65
4. Tasman AJ (1999)Polyposis nasi: systemic cortisone therapy is suitable for prevention or pretreatment before surgery. MMW Progress Med 141:80.