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History of nasal polyp

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This presentation discusses history of nasal polypi

This presentation discusses history of nasal polypi


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  • 1. History of Nasal polyposis Dr T Balasubramanian
  • 2. Introduction
    • Nasal polypi first reported 4000 years ago
    • 3. Egyptians were pioneers in diagnosis & trt of nasal polypi
    • 4. Egyptians were familiar with nasal anatomy as they used this route to suck out the brain contents during mummification procedures
    • 5. Samuel of Egypt described a large polyp hanging in the throat strangulating a patient
  • 6. Contribution of Hippocrates
    • Father of Rhinology
    • 7. Coined the term polyp
    • 8. This term was used because they resembled sea polyp
    • 9. First described the surgical procedure to remove nasal polypi
    ” Nasal polyps are sacs of phlegm that cause nasal obstruction and deranges the sense of smell” Hippocrates
  • 10. Etiopathology
    • 1 st Century AD – Celsus documented nasal polypi enlarged in size during moist weather
    • 11. Celsus hypothesized nasal polypi to be local manifestation of systemic disorder
    • 12. Boerhaave hypothesized nasal polyp to be elongated nasal mucosa - 17 th century
    • 13. Mann & Heister – Nasal polypi are formed due to obstruction of mucosal glands
    “ A Nasal polyp shows itself by bad smell of the nose” Samuel
  • 14. Billroth hypothesis
    • Billroth demonstrated that nasal polypi microscopically resembled nasal mucosa
    • 15. He also postulated nasal infections somehow could play a role in the genesis of polypi
    • 16. In his classic treatise published in1843 he concluded that nasal polypi could be nothing but hypertrophic nasal mucosa
  • 17. Virchow's hypothesis
    • Considered nasal polyp to be primary tumors like fibroma / myxoma
    • 18. Stressed on the relationship between the age of occurence and nasal deformity
  • 19. Eggston's theory
    • Nasal polypi are formed due to vascular changes in the submucosal blood vessels
    • 20. These changes are caused by inflammation and periphlebitis
    • 21. The passive oedema of nasal mucous membrane is caused by venous stasis
  • 22. Burn's theory
    • Also known as mucopolysaccharide theory
    • 23. Mucopolysaccharides present in the stroma could somehow play a role in the pathogenesis of nasal polypi
    • 24. Stromal mucopolysaccharides under go changes in response to allergy and nasal mucosal inflammation causing the mucosa to swell
  • 25. Berden's theory
    • Nasal polypi could be caused due to allergic inflammation of nasal mucosa
    • 26. He was able to demonstrate the reagin responsible for inflammation of nasal mucosa
    • 27. Allergic reactions involving the nasal mucosa caused mucosal oedema
  • 28. Syndromes associated with nasal polyp
    • Lurie described the association between nasal polypi and cystic fibrosis in 1959
    • 29. Samter & Beer described the classic samter's triad in 1969.
    • 30. Components of samter's triad include – nasal polypi, aspirin hypersensitivity and bronchial asthma
  • 31. Instruments used to examine the nasal cavity
    • Hippocrates designed a tubular nasal speculum inspired by the speculum designed by Hindu surgeons of yesteryears
    • 32. Hildanus designed the currently available nasal speculum. Hildanus speculum underwent different modifications to evolve into its present form
    • 33. Morrel Mecenzie used mirrors to reflect sunlight to examine the nasal cavity
  • 34. Medical Management
    • Hippocrates used tampoons dipped in honey and pepper
    • 35. Celsus used caustic agents to treat nasal polypi
    • 36. Galen used oil of turpentine to treat nasal polyp
    • 37. Daniel Bovet used antihistamines in the treatment of nasal polypi for the first time
  • 38. Surgical management
    • Rolando of Italy used strings with knots to remove nasal polypi
    • 39. Hippocrates described a method of removing the nasal polypi and delivering it via the post nasal space by using a large tampoon which can be pushed into the nasal cavity there by dislodging the polypi
  • 40. Thank you