Epidemiology of nasal polyp
Dr T Balasubramanian
Introduction
Lots of development has taken place in the study of epidemiology
of nasal polypi
Still lots of questions remains unanswered
It could best be described as a clinical manifestation of co
existing multiple immunologic pathways
Epidemiological perspectives
The prevalance of nasal polyp is 1-3%
Links between nasal polyp and allergic rhinitis is rather
weak
There is a strong association between asthma & nasal
polyp
The incidence increases with age
Incidence of aspirin hypersensitivity in patients with nasal
polyp is high
Contd...
Genetic predisposition is unclear
Nasal polypi in children Cystic fibrosis to be ruled out
AFRS is commonly associated with nasal polyposis
Classification of chronic rhinosinusitis
Chronic rhinosinusitis without nasal polypi
Chronic rhinosinusitis with nasal polypi
Chronic rhinosinusitis without nasal polypi
Commonly seen in TH1 mediated inflammation
TH1 lymphocytes are potent inducers of inflammation
If antrochoanal polyp is present should be differentiated from
bilateral ethmoidal polypi
Chronic rhinosinusitis with nasal polypi
This is caused by TH2 mediated inflammation
This type of inflammation is seen in patients with bronchial
asthma
TH1 & TH2 mediated inflammation
TH1 & TH2 responses are T helper cell responses which are
produced in response to infections / inflammation
Both these responses should be optimal to enable the body to get
rid of infection
Disease tends to occur when either of them predomonates over the
other
Contd.
Cytokines secreted by T helper cells type I are proinflammatory
cytokines
Cytokines secreted by T helper cells type II are
anti-inflammatory cytokines. These cytokines are seen during
allergic response
Comorbid conditions associated with nasal polypi
Allergic rhinitis
General atopic status
Bronchial asthma
Highlights
No significant increase in the incidence of nasal polyposis in
patients with nasal allergy
Incidence of nasal polypi is 4 times more in patients with
asthma
Incidence of atopy was more in patients with nasal polypi than
in normal population
AFRS is commonly associated with nasal polypi
Pointers for diagnosis of AFRS
Type I hypersensitivity to Demataceous fungi
CT scan findings Inspissated secretions with calcification
Eosinophilic nasal secretions with the presence of Charcot
Leyden crystals
Positive isolation of fungal material from sinus contents
Thankyou
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