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Published on: June 20, 2018
Nasal polyposis in children
1Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, 2-27100 Pavia PV, Italy.
Insights
Pediatric nasal polyposis is uncommon but can signal underlying diseases like cystic fibrosis. Early diagnosis via nasal endoscopy and a multidisciplinary approach are crucial for effective treatment.
Area of Science:
- Otolaryngology
- Pediatric Pulmonology
- Allergy and Immunology
Background:
- Nasal polyposis (NP) is a chronic inflammatory sinonasal disease, affecting 1-4% of the general population.
- NP is rarely documented in pediatric populations, often associated with systemic conditions like cystic fibrosis (CF).
Purpose of the Study:
- To characterize pediatric nasal polyposis patients evaluated at the University of Pavia over 17 years.
- To identify key clinical features, diagnostic findings, and treatment approaches in this cohort.
Main Methods:
- Retrospective analysis of 56 pediatric patients diagnosed with NP.
- Evaluations included allergy testing, nasal endoscopy, CT scans, and Functional Endoscopic Sinus Surgery (FESS).
Main Results:
- Mean age was 11.8 years; most patients were male.
- 50% presented with unilateral polyposis, often antrochoanal polyps.
- Four patients with bilateral NP had cystic fibrosis; 32% showed allergen sensitivity.
Conclusions:
- Pediatric NP can be an indicator of underlying systemic diseases, necessitating thorough investigation.
- Nasal endoscopy is vital for suspected cases; a multidisciplinary approach integrating medical and surgical expertise is essential for optimal management.
Abstract:
Nasal polyposis is a chronic inflammatory disease affecting the nasal cavity and the paranasal sinuses. It is a relatively common disease, occurring in 1-4 % of the general population, but it is rarely described in the pediatric population. Most of the published series include children presenting with other underlying systemic diseases, mainly cystic fibrosis. The aim of the present study was to describe the characteristics of the patients suffering from nasal polyposis, evaluated at the Pediatric Clinic of the University of Pavia (Italy) over the last 17 years. 56 consecutive pediatric patients referring to our Pediatric Department had a diagnosis of nasal poyposis over the last 17 years. All children underwent allergy evaluation, nasal endoscopy, CT scan of the paranasal sinus, and Functional Endoscopic Sinus Surgery. The mean age of the present cohort was of 11.8 years and most of the patients were male. 50% of the patients presented with unilateral, polyposis, mostly with a diagnosis of antrochoanal polyp. 4 patients presenting with bilateral polyposis suffered from cystic fibrosis. Main symptoms at diagnosis included nasal obstruction, snoring and rhinorrhea 32% of the patients presented at least a positivity to skin prick test, for major inhalant and food allergens. Nasal polyposis in children could represent an alert sign for other underlying systemic diseases. Nasal endoscopy should therefore be prescribed when a diagnosis is suspected. To properly treat a patient presenting with nasal polyposis, it is necessary to integrate medical and surgical skills through a multidisciplinary approach.
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