Chronic Rhinosinusitis and Nasal Polyps

Chronic Rhinosinusitis and Nasal Polyps

Nasal polyps, inflammatory outgrowths of nasal-sinus tissue, occur in one to four percent of the U.S. general population. Nasal polyps are frequently associated with a subgroup of chronic rhinosinusitis
labeled chronic rhinosinusitis with nasal polyp (CRSwNP).

Among all patients with CRS only 25-30 percent has CRSwNP. However, CRSwNP is associated with significant morbidity and decreased quality of life, which makes this disease clinically important to identify, fully evaluate, and target specific treatment. While men are more likely to be affected than women, currently no specific genetic or environmental factors have been linked to the development of the disorder.

CRSwNP is frequently associated with asthma, allergic rhinitis, and aspirin hypersensitivity. Additionally, factors such as a defect in the nasal-sinus epithelial cells barrier,increased exposure to and colonizing pathogenic organisms, and/ or injunction with dysregulation of the host immune system, are thought to play prominent roles in developing CRSwNP.

CRSwNP commonly affects middle-aged men, with the average age of onset near 40 years old. Nasal polyps present as bilateral inflammatory outgrowths originating in the sinuses and projecting into the nasal airway. Patients often experience severe nasal obstruction and loss of smell/taste. The diagnosis is based on sinus CT scan and nasal endoscopy. In general, patients with CRSwNP have more severe nasal-sinus symptoms than patients diagnosed with CRS without polyps, and the diagnosis is usually associated with asthma or allergic rhinitis.