Epidemiology of nasal polyp Dr T Balasubramanian
Introduction <ul><li>Lots of development has taken place in the study of epidemiology of nasal polypi
Still lots of questions remains unanswered
It could best be described as a clinical manifestation of co existing multiple immunologic pathways </li></ul>
Epidemiological perspectives <ul><li>The prevalance of nasal polyp is 1-3%
Links between nasal polyp and allergic rhinitis is rather weak
There is a strong association between asthma & nasal polyp
The incidence increases with age
Incidence of aspirin hypersensitivity in patients with nasal polyp is high </li></ul>
Contd... <ul><li>Genetic predisposition is unclear
Nasal polypi in children – Cystic fibrosis to be ruled out
AFRS is commonly associated with nasal polyposis </li></ul>
Classification of chronic rhinosinusitis <ul><li>Chronic rhinosinusitis without nasal polypi
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Epidemiology of nasal polypi

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Epidemiology of nasal polypi

  1. 1. Epidemiology of nasal polyp Dr T Balasubramanian
  2. 2. Introduction <ul><li>Lots of development has taken place in the study of epidemiology of nasal polypi
  3. 3. Still lots of questions remains unanswered
  4. 4. It could best be described as a clinical manifestation of co existing multiple immunologic pathways </li></ul>
  5. 5. Epidemiological perspectives <ul><li>The prevalance of nasal polyp is 1-3%
  6. 6. Links between nasal polyp and allergic rhinitis is rather weak
  7. 7. There is a strong association between asthma & nasal polyp
  8. 8. The incidence increases with age
  9. 9. Incidence of aspirin hypersensitivity in patients with nasal polyp is high </li></ul>
  10. 10. Contd... <ul><li>Genetic predisposition is unclear
  11. 11. Nasal polypi in children – Cystic fibrosis to be ruled out
  12. 12. AFRS is commonly associated with nasal polyposis </li></ul>
  13. 13. Classification of chronic rhinosinusitis <ul><li>Chronic rhinosinusitis without nasal polypi
  14. 14. Chronic rhinosinusitis with nasal polypi </li></ul>
  15. 15. Chronic rhinosinusitis without nasal polypi <ul><li>Commonly seen in TH1 mediated inflammation
  16. 16. TH1 lymphocytes are potent inducers of inflammation
  17. 17. If antrochoanal polyp is present should be differentiated from bilateral ethmoidal polypi </li></ul>
  18. 18. Chronic rhinosinusitis with nasal polypi <ul><li>This is caused by TH2 mediated inflammation
  19. 19. This type of inflammation is seen in patients with bronchial asthma </li></ul>
  20. 20. TH1 & TH2 mediated inflammation <ul><li>TH1 & TH2 responses are T helper cell responses which are produced in response to infections / inflammation
  21. 21. Both these responses should be optimal to enable the body to get rid of infection
  22. 22. Disease tends to occur when either of them predomonates over the other </li></ul>
  23. 23. Contd. <ul><li>Cytokines secreted by T helper cells type I are proinflammatory cytokines
  24. 24. Cytokines secreted by T helper cells type II are anti-inflammatory cytokines. These cytokines are seen during allergic response </li></ul>
  25. 25. Comorbid conditions associated with nasal polypi <ul><li>Allergic rhinitis
  26. 26. General atopic status
  27. 27. Bronchial asthma </li></ul>
  28. 28. Highlights <ul><li>No significant increase in the incidence of nasal polyposis in patients with nasal allergy
  29. 29. Incidence of nasal polypi is 4 times more in patients with asthma
  30. 30. Incidence of atopy was more in patients with nasal polypi than in normal population
  31. 31. AFRS is commonly associated with nasal polypi </li></ul>
  32. 32. Pointers for diagnosis of AFRS <ul><li>Type I hypersensitivity to Demataceous fungi
  33. 33. CT scan findings – Inspissated secretions with calcification
  34. 34. Eosinophilic nasal secretions with the presence of Charcot Leyden crystals
  35. 35. Positive isolation of fungal material from sinus contents </li></ul>
  36. 36. Thankyou

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