nasal polyp

• 鼻茸、鼻ポリープ

WordNet

1. a small vascular growth on the surface of a mucous membrane (同)polypus
2. one of two forms that coelenterates take (e.g. a hydra or coral): usually sedentary with a hollow cylindrical body usually with a ring of tentacles around the mouth; "in some species of coelenterate, polyps are a phase in the life cycle that alternates with a medusoid phase"
3. an elongated rectangular bone that forms the bridge of the nose (同)nasal_bone, os_nasale

PrepTutorEJDIC

1. ポリプ(ヒドラ,イソギンチャクなどの生物)・ポリープ(鼻などの粘膜にできるおでき)
2. 《名詞の前にのみ用いて》鼻の / 鼻声の / (音声が)鼻音の / (音声で)鼻音;鼻音字([m][n][g])
3. =polytechnic
4. 《話》政治家

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/05/18 10:52:04」(JST)

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Nasal polyps
A nasal polyp
Classification and external resources
Specialty	Otorhinolaryngology
ICD-10	J33
ICD-9-CM	471
MedlinePlus	001641
eMedicine	ent/334 ent/335
MeSH	C09.603.557

Nasal polyps (NP) are non cancerous growths within the nose or sinuses. Symptoms include trouble breathing through the nose, loss of smell, decreased taste, post nasal drip, and a runny nose. The growths are sac-like, movable, and nontender. They typically occur in both nostrils in those who are affected. Face pain may occasionally occur. Complications may include sinusitis.

The exact cause is unclear. They occur more commonly among people who have allergies, cystic fibrosis, aspirin sensitivity, or certain infections. They are overgrowths of the mucous membranes. Diagnosis may occur by looking up the nose and a CT scan may be used to help plan treatment.

Treatment is typically with steroids, often in the form of a nasal spray. If this is not effective surgery may be considered. The condition may recur following surgery. Antihistamines may help with symptoms but do not change the underlying disease. Antibiotics are not required unless complications occur. About 4% of people currently have nasal polyps while up to 40% of people develop them at some point in their life. They most often occur after the age of 20 and are more frequent in males than females.

Signs and symptoms

Nasal polyps are usually classified into antrochoanal polyps and ethmoidal polyps. Antrochoanal polyps arise from the maxillary sinuses and are the much less common; ethmoidal polyps arise from the ethmoidal sinuses.

Symptoms of polyps include nasal congestion, sinusitis, anosmia (loss of smell), and secondary infection leading to headache. They may be removed by surgery, but are found to recur in about 70% of cases. Sinus surgery requires a great amount of precision as this involves risk of damage to orbit matter.

Causes

Micrograph of a sinonasal papilloma (H&E stain), which may have serious consequences and should be distinguished from nasal polyps

The pathogenesis of nasal polyps is unknown. Nasal polyps are most commonly thought to be caused by allergy and rarely by cystic fibrosis although a significant number are associated with non-allergic adult asthma or no respiratory or allergic trigger that can be demonstrated. Nasal mucosa, particularly in the region of middle meatus becomes oedematous due to collection of extracellular fluid causing polypoidal change. Polyps which are sessile in the beginning become pedunculated due to gravity and excessive sneezing.

In early stages, surface of nasal polyp is covered by ciliated columnar epithelium, but later it undergoes metaplastic change to squamous type on atmospheric irritation. Submucosa shows large intercellular spaces filled with serous fluid.

There are various diseases associated with polyp formation:

1. Chronic rhinosinusitis
2. Asthma
3. Aspirin-induced asthma, or aspirin-exacerbated respiratory disease (AERD)
4. Cystic fibrosis
5. Allergic fungal sinusitis
6. Kartagener's syndrome
7. Young's syndrome
8. Eosinophilic granulomatosis with polyangiitis
9. Nasal mastocytosis

Exposure to some forms of chromium can cause nasal polyps and associated diseases. Chronic rhinosinusitis is a common chronic medical condition that can be classified into two groups presenting either with nasal polyposis or without. Chronic rhinosinusitis with nasal polyposis can be divided into eosinophilic chronic rhinosinusitis, which include allergic fungal rhinosinusitis and aspirin-exacerbated respiratory disease, or nasal polyps associated with neutrophilic inflammation, which is primarily characterized by cystic fibrosis.

Diagnosis

There are two criteria (major and minor) that must be met. The former in the form of facial pressure, nasal blockage, decreased smell and the latter in the form of fever, headache, cough and dental pain.

On a CT scan, a nasal polyp generally has an attenuation of 10-18 Hounsfield units, but this is similar to that of mucus. Yet, nasal polyps may have calcification.

Types

Human nasal polyp, magnification 25x, (H&E stain)

There are two major types of nasal polyp.

1. Antrochoanal
   1. Single, Unilateral
   2. Can originate from maxillary sinus
   3. Usually found in children
2. Ethmoidal
   1. Bilateral
   2. Usually found in adults

Nasal polyps consist of hyperplastic oedematous connective tissue with some seromucous glands and inflammatory cells (mostly neutrophils and eosinophils) with respiratory epithelium, sometimes with metaplastic squamous epithelium on the surface. Nasal polyps should be distinguished from nasal papillomas, which are benign epithelial tumors and have more serious consequences.

Treatment

Sodium bicarbonate

Nasal polyps are most often treated with steroids or topical, but can also be treated with surgical methods. Before and after surgery, sinus rinses with sterile warm water mixed with a small amount of salts (sodium chloride and sodium bicarbonate) can be helpful to clear the sinuses.

The removal of nasal polyps via surgery lasts approximately 45 minutes to 1 hour. The surgery can be done under general or local anaesthesia, and the polyps are removed using endoscopic surgery. Recovery from this type of surgery is anywhere from 1 to 3 weeks. Mometasone furoate, commonly available as a nasal spray for treating common allergy symptoms, has been indicated in the United States by the FDA for the treatment of nasal polyps since December 2005.

References

Further reading

• Meymane Jahromi, Ahmad; Shahabi Pour, Ayeh (1 January 2012). "The Epidemiological and Clinical Aspects of Nasal Polyps that Require Surgery". Iranian Journal of Otorhinolaryngology. 24 (67): 75–78. ISSN 2251-7251. PMC 3846212 . PMID 24303389. 

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 鼻閉塞の臨床症状、診断、および治療 clinical presentation diagnosis and treatment of nasal obstruction
• 2. Chronic rhinosinusitis: Management
• 3. 鼻症状の原因：概要 etiologies of nasal symptoms an overview
• 4. アスピリンによる呼吸器疾患の増悪 aspirin exacerbated respiratory disease
• 5. 慢性副鼻腔炎：臨床症状、病態生理、および診断 chronic rhinosinusitis clinical manifestations pathophysiology and diagnosis

English Journal

• Barrier function of the nasal mucosa in health and type-2 biased airway diseases.

• Zhang N1, Van Crombruggen K1, Gevaert E1, Bachert C1,2.
• Allergy.Allergy.2016 Mar;71(3):295-307. doi: 10.1111/all.12809. Epub 2016 Jan 13.
• The mucosal lining of the upper airways represents the outer surface of the body to the ambient air and its contents and is prepared for it as the first line of defense. Apart from the well-described physical barrier and the mucociliary clearance, a variety of systems, including the airway microbiom
• PMID 26606240

• Effects of Fluticasone Furoate on Clinical and Immunological Outcomes (IL-17) for Patients With Nasal Polyposis Naive to Steroid Treatment.

• Venkatesan N1, Lavigne P2, Lavigne F3, Hamid Q1.
• The Annals of otology, rhinology, and laryngology.Ann Otol Rhinol Laryngol.2016 Mar;125(3):213-8. doi: 10.1177/0003489415606449. Epub 2015 Sep 24.
• OBJECTIVES: We investigated the effect of topical steroids on clinical outcomes and related immune response of chronic rhinosinusitis with nasal polyp (CRSwNP) patients and in eradicating some polyps. We want to explore a new potential mechanism linked to Th-17 cells.METHODS: Prospective, double-bli
• PMID 26405064

• Effectiveness of leukotriene receptor antagonism in the postoperative management of chronic rhinosinusitis.

• Yelverton JC1, Holmes TW1, Johnson CM1, Gelves CR2, Kountakis SE1.
• International forum of allergy & rhinology.Int Forum Allergy Rhinol.2016 Feb 2. doi: 10.1002/alr.21649. [Epub ahead of print]
• BACKGROUND: Montelukast is used in the treatment of allergic rhinitis and asthma. It has been used as adjuvant therapy in patients with chronic rhinosinusitis (CRS), but its effectiveness has not been evaluated. This study evaluates the efficacy of adjuvant leukotriene receptor antagonism in CRS and
• PMID 26834076

Japanese Journal

• 薬物 鼻茸を伴うアレルギー性鼻炎疑い例に対するサルコート鼻内噴霧の使用経験

• 耳鼻咽喉科臨床 108(11), 877-882, 2015-11
• NAID 40020642450

• 好酸球性鼻副鼻腔炎(<シリーズ>アレルギー用語解説)

• アレルギー 64(2), 156-157, 2015-03-01
• NAID 110009917676

• One airway, one disease : 慢性副鼻腔炎:鼻ポリープ (特集 気管支喘息の併存症をめぐって)

• 呼吸器内科 27(3), 180-186, 2015-03
• NAID 40020404771

Related Links

• Nasal polyp treatment

Nasal polyps treatment Nasal polyps can be described as an inflammation on the nose or the sinus lining. These linings are most common in adults than in children. Adults who suffer from asthma attacks of the sinus infection or even ...

• 鼻茸(以下nasal polypと言います) について。

鼻茸(以下nasal polypと言います)は 鼻腔、副鼻腔(管腔臓器)の鼻粘膜組織 の粘膜表皮（上皮細胞）に広く分布する海綿体組織が 化膿菌の炎症によりポリープに病変したものです。 nasal polypの外観は火傷の水ぶくれと良く類似しています。

Related Pictures

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★リンクテーブル★

リンク元	「鼻ポリープ」
関連記事	「nasal」「poly」

「鼻ポリープ」

　　[★]

英

nasal polyp, rhinopolypus

ラ

polypus nasales

同

鼻茸

関

アスピリン喘息

「nasal」

　　[★]

• adj.

• 鼻の、経鼻の

関

nasotracheal、nose、snout、transnasal

　 　

「poly」

　　[★]

• comb form.

• ポリ、多

関

multi