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Nasal polyposis: clinical course during 20 years
S I Vento1, L O Ertama, M L Hytönen
1Department of Otorhinolaryngology, Helsinki University Central Hospital, Finland. doctor.vento@fimnet.fi
Summary
Nasal polyposis frequently recurs, affecting 85% of patients after 20 years. Long-term monitoring is essential due to persistent symptoms and high recurrence rates in nasal polyposis patients.
Area of Science:
- Otolaryngology
- Allergy and Immunology
- Respiratory Medicine
Background:
- The exact causes of nasal polyposis remain largely unknown.
- Long-term outcomes and recurrence rates of nasal polyposis are poorly documented.
Purpose of the Study:
- To investigate the long-term clinical course of nasal polyposis over a 20-year period.
- To assess the recurrence and associated conditions in patients with nasal polyposis.
Main Methods:
- A 20-year follow-up study involved 41 patients previously treated for nasal polyposis.
- Patients were categorized by acetylsalicylic acid (ASA) intolerance, atopic allergy (AT), or intrinsic allergy-like disease (INTR).
- Re-examination included rhinoscopy, sinus CT scans, and biopsies.
Main Results:
- Nasal polyposis remained active in 85% of patients after 20 years, with universal paranasal sinus mucosal changes.
- Anosmia/hyposmia affected 61% of patients. Eight patients underwent 11+ surgeries, predominantly in the ASA-intolerant group.
- Bronchial asthma was prevalent in all ASA-intolerant patients (100%) and common in AT (36%) and INTR (16%) groups.
Conclusions:
- Nasal polyposis exhibits a high tendency for recurrence.
- Insidious symptoms necessitate lifelong follow-up for nasal polyposis patients.
- Identifying patient subgroups, like those with ASA intolerance, is crucial for managing associated conditions such as asthma.