Site of origin of nasal polyps: relevance to pathogenesis and management.
The site of origin of sino-nasal polyps was documented in 113 consecutive patients undergoing functional endoscopic sinus surgery (FESS). These patients were assigned pre-operatively to 4 clinical groups according to the out-patient recorded endoscopic appearance of their nasal cavities; chronic rhinosinusitis without polyps (CRSS) n=35, grade 1 polyps n=28, grade 2 polyps n=30 and grade 3 polyps n=20. In the group of patients diagnosed with polyps pre-operatively, 97.4% had polyps originating in the anterior ethmoid complex, of which 89.7% had polyps originating in the anterior ethmoidal cells and over 60% had polyps specifically originating from each of the following sites: the uncinate or infundibulum, the posterior ethmoid sinus, the frontal recess and the face of the bulla ethmoidalis. In the group diagnosed pre-operatively as CRSS without polyps, polyps were found in 60% of patients within the sinuses during surgery. In summary, our findings suggest that polyps originate from the middle meatus, and may be found at surgery when undetectable at pre-operative endoscopy.
Andrews
A E
AE
ENT Department, Royal Surrey County Hospital, Egerton Road, Guildford, United Kingdom.
Bryson
J M
JM
Rowe-Jones
J M
JM
D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology; D009298:Nasal Polyps / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D010256:Paranasal Sinuses / Q000473:pathology; D012220:Rhinitis / Q000150:complications / Q000473:pathology* / Q000601:surgery; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications / Q000473:pathology* / Q000601:surgery