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Year : 2016  |  Volume : 29  |  Issue : 3  |  Page : 469-477

Update of pathogenesis and management of nasal polyposis

1 Department of Otolaryngology, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
2 Department of Surgery, ENT Division, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
3 ENT Department, Electrical Hospital, Ministry of Electricity, Cairo, Egypt; Department of ENT, Ibri Referral Hospital, Ministry Of Health, Ibri, Oman

Correspondence Address:
Fawzy Fayaz
MBBCh, Kafer Al Mosulaha, Shebine Al Kom City, Menoufiya Governorate, Menoufiya, 32511, Egypt

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.198570

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Objectives The goal of this article is to review important and recent findings relating to the pathogenesis and management of nasal polyposis (NP). The rationale for a disease classification based on histopathological characteristics and current concepts in therapeutic approach toward managing the condition are summarized. Data sources The data sources are PubMed systemic reviews and all materials on the internet from 2004 to 2014. Study selection The initial search presented 6692 articles, of which 40 met the inclusion criteria: systemic review, clinical trial types II and III, meta-analysis, published in English language, published in peer-reviewed journals, and focusing on epidemiology, pathogenesis, and management of NP. Data extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included ethical approval, eligibility criteria specified, appropriate controls, and adequate information. Data synthesis Recommendations received were revised for the strength of evidence and strength of recommendation then available data were tabulated. Findings Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a predominantly inflammatory disease associated with dysregulated interaction between sinus epithelium and the innate lymphoid system. Recent research suggests that chronic rhinosinusitis is neither an eosinophilic nor a neutrophilic disorder. The goal in CRSwNP/ eosinophilic chronic rhinosinusitis is to create a wide postsurgical corridor rather than simple polypectomy for effective delivery of topical anti-inflammatory therapy. Conclusion New classification of CRSwNP based on the endotyping characters will facilitate the development of managements and establish genetic associations, demonstrate biomarkers for disease subgroups, and test novel therapeutic targets until the question of NP control has been answered.

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