Nasal Polyps (Polyposis Nasi)

In nasal polyps (lat. Polyposis nasi; synonyms: “polyposis nasi et sinuum,” sinuum = paranasal sinus; polypoid nasal hyperplasia; polypoid sinus degeneration; polypoid rhinopathy; polypoid adenoid tissue; polyposis of the paranasal sinuses; polyposis of the ethmoid sinus; polyposis of the maxillary sinus; polyposis of the sphenoid sinus; polyposis nasi deformans; ICD-10-GM J33. -: Other polyps of the paranasal sinuses (polyp, polyposis)) are benign tissue growths of the nasal mucosa. Nasal polyps develop in the paranasal sinuses (lat. Sinus paranasales) and grow from there into the main nasal cavity (Cavum nasi proprium).Particularly predisposed to the formation of polyps are the ethmoid sinus (Sinus sphenoidalis) and the sphenoid sinus (Sinus sphenoidalis). Nasal polyps can be classified according to their location, the presence of unilateral or bilateral polyps, and dependence on underlying diseases, among other factors:

  • Localization:
    • Antrochoanal polyps (maxillary sinus: maxillary sinus): usually unilateral and solitary; grows over a long style through the maxillary sinus opening down into the nasopharynx; there it develops into a “true” polyp
    • Ethmoidal polyps (sphenoidal sinus: ethmoidal sinus): bilateral and multiple of varying size.
    • Polyps of the sphenoid sinus (sphenoidal sinus).
  • Unilateral or bilateral:
  • Polyposis in underlying diseases:

Notice: When the vernacular speaks of “polyps”, the adenoids (adenoid vegetations; enlargements (hypertrophies) of the lymphoepithelial tissue, that is, the Rachentonsille / adenoids) are meant. They have nothing to do with the “true” polyps of the nasal passage (polyposis nasi), which usually occur in the majority. Nasal polyps often occur together with chronic rhinosinusitis (CRS): Chronic rhinosinusitis (CRS): defined as persistence of nasal obstruction and/or secretion problems > 12 weeks; possibly accompanied by cough, facial pain or pressure, and/or limitations of smellDefinition of CRS according to S2k guideline (see below): persistent symptoms > 12 weeks:

Legend: cNP with (cum) nasal polyps; sNP without (sine) nasal polyps.

Sex ratio: males are affected twice as often as females. Frequency peak: nasal polyps can develop at any age. Most often, they appear after the age of 30. The prevalence (disease incidence) of nasal polyps is 4% (in Germany).The prevalence of chronic rhinosinusitis (CRS) is estimated at 5-15% of the population. CRScNP affects approximately 1-4 % of the general population. Course and prognosis: Initially, nasal polyps often go unnoticed. They are first noticed by obstruction of nasal breathing. As soon as the paranasal sinuses are also affected, further symptoms occur, such as secretion discharge via the pharynx and/or from the nose, as well as facial pain or pain or a feeling of pressure in the area of the affected paranasal sinus. As a result of the disease, pharyngitis (inflammation of the pharynx), laryngitis (inflammation of the larynx) or bronchitis (inflammation of the mucous membrane in the bronchial tubes) frequently occur. These diseases are typically accompanied by sore throat, hoarseness and cough.The main measure of therapy is the elimination of the cause of the inflammatory process. After successful therapy, the prognosis is good.However, in the case of cystic fibrosis (ZF) or allergies, the occurrence of a relapse is very likely. The recurrence rate is reported to be about 50%.After surgery, about 90% of patients report a significant improvement in symptoms.Comorbidities (concomitant diseases): The disease is often associated with chronic rhinosinusitis (simultaneous inflammation of the nasal mucosa (“rhinitis”) and the mucosa of the paranasal sinuses (“sinusitis“)), bronchial asthma (40% of patients with CRSCNP (with (cum) nasal polyps)) and acetylsalicylic acid intolerance. Leiltin lines

  1. S1 guideline: diagnosis and therapy of sinusitis and polyposis nasi. (AWMF register number: 061-015), October 2008.
  2. S2k guideline: rhinosinusitis. (AWMF register number: 017-049), April 2017 Abstract Long version.