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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
12/1/06
Chronic sinusitis with and without nasal polyps
Summary
Background - It is unclear whether chronic rhinosinusitis (CRS) with nasal polyposis (NP) and CRS without NP are different stages of the same disease or whether they are two different diseases.
Findings - Polzehl et al of the Univ of Ulm in Germany compared the histopathologic patterns in the nasal/sinus mucosa in those with CRS with early NP formation vs the histopathology in CRS with no NP seen grossly. They found that the inflammatory responses, including round cells, plasma cells and eosinophils were significantly greater in the ethnoid area in those with very small polyps in the non-adjacent infundibular area of the nasal/sinus structures when compared with findings in those without NP.
Reference
Allergy 2006;61:1275-79
Editor's Comments
The authors concluded that their findings suggested that CRS with NP is a different disease than CRS without NP based on histopathologic differences in tissues not involved by the NP itself. However, one can argue that the greater inflammatory response seen is just a prelude to NP development. Of note, the authors found no difference in the frequency of IgE-positive cells or mast cells in those with and without NP. Other studies suggest a Th2 polarization in CRS when NP is present (but a Th1 type in CRS without NP).
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