The cytological research in nasal polyposis (original) (raw)
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Global Journal of Otolaryngology, 2017
Nasal polyp is a benign lesion that arises from the mucosa of the nasal sinuses or from the mucosa of the nasal cavity as a macroscopic edematous mass. The exact etiology is still unknown and controversial, but it is assumed that main causes are inflammatory conditions and allergy. It is more common in allergic patients with asthma. Interleukin-5 has found to be significantly raised in nasal polyps. The patients usually present with nasal obstruction, rhinorrhea and postnasal drip. Magnetic resonance imaging is suggested, particularly to rule out serious conditions such as neoplasia. Histopathological examination is also suggested to rule out malignancy and for definite diagnosis.
Immunological face of nasal polyposisa short narrative review
zeichen, 2022
Nasal polyps (NP) are benign lesions that develop from the mucosa of the nasal sinuses or the mucosa of the nasal cavity. Local and systemic steroids form the mainstay in the medical management of the disease. Innumerable biomarkers like, IgE, Cytokines, chemokines, nitric oxide, periostin, autoimmunity, glycoprotein and many others have been implicated in the pathogenesis of the disease. Recurrence after surgery also is a big hurdle in the pathway of its treatment. Introducing monoclonal antibodies to target biomarkers have largely come up in the management. The knowledge of phenotypic classification has also changed the management of the disease. Doxycycline and clarithromycin have proved to have actions on biomarkers than bacteria to be useful specifically in this condition. Omalizumab an anti IgE monoclonal antibody treatment for four months can significantly improve the symptoms. Dupilumab, affects the two critical cytokines of Th2 immune response (i.e. IL-4 and IL-13). Both clinical and biomarker improvement have been found with treatment with the drug in cases of nasal polyps. Verapamil, an anti-arrhythmic and antihypertensive, is also found to be useful as an antiglycoprotein in this condition. Apart from steroids and surgery, newer biomarker targeted drug therapy may play a major role in the future.
Nasal Polyposis: An Overview of Differential Diagnosis and Treatment
Recent Patents on Inflammation & Allergy Drug Discovery, 2011
Nasal polyposis is a chronic inflammatory disease of the nasal and paranasal sinus mucosa. Etiology remains unclear, but allergy, asthma, aspirin sensitivity, cystic fibrosis, and infection have been associated with the disease. Clinically, nasal obstruction, anosmia/hyposmia, rhinorrhea, postnasal drainage, headaches, facial pain, and sleep disorders constitute the main symptoms. Intranasal examination reveals bilateral, mobile, grey, smooth and semi translucent polypoid masses that usually originate in the ethmoid sinuses or the middle meatus. Differential diagnosis is important to rule out congenital anomalies, as well as benign or malignant tumors. In the evaluation of nasal polyps, computerized tomography is helpful especially in determining the extent of the disease and in planning the surgical approach. Management of nasal polyposis consists of medical therapy and surgery. Surgical treatment is performed in cases that are refractory to medical therapy. Recurrence of nasal polyps is quite common and medical therapy after surgery is often necessary for avoiding recurrences. This paper aims to summarize the current trends in the diagnosis, management of nasal polyposis and relevant patents.
Nasal cytology: practical aspects and clinical relevance
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2016
Nasal cytology is a simple and safe diagnostic procedure that allows to assess the normal and pathological aspects of the nasal mucosa, by identifying and counting the cell types and their morphology. It can be easily performed by a nasal scraping followed by May-Grunwald-Giemsa staining and optical microscopy reading. This procedure allows to identify the normal cells (ciliated and mucinous), the inflammatory cells (lymphocytes, neutrophils, eosinophils, mast cells), and bacteria or fungal ifae/spores. Apart from the normal cell population, some specific cytological patterns can be of help in discriminating among various diseases. Viral infections, allergic rhinitis, vasomotor rhinitis and overlapping forms can be easily identified. According to the predominant cell type, various entities can be defined (named as NARES, NARESMA, NARMA). This implies a more detailed knowledge and assessment of the disease, that can integrate the standard diagnostic procedures. Nasal cytology also re...
Nasal polyposis: A semiquantitative morphometric histopathological study
Military Medical and Pharmaceutical Journal of Serbia, 2018
Background / Aim. Nasal polyps are inflammatory hypertrophic proliferations of the sinonasal mucosa composed of both epithelial and stromal elements. The aim of this study was to determine histopathological hallmarks of nasal polyposis via semiquantitative morphometric study. Methods. Study was designed as prospective study with semiquantitative morphometric analysis and it comprised 77 patients with chronic rhinosinusitis and nasal polyposis that underwent functional endoscopic sinonasal surgery performed by the same surgeon. Morphometric analysis included gradation of tissue edema within polyps, thickening of epithelial basal membrane, degree of inflammation, presence/absence of metaplasia within epithelium, degree of fibrosis within polyps, and percentage of inflammatory cells within inflammatory infiltrate (lymphocytes, macrophages, plasma cells, neutrophils and eosinophils). Results. As expected, samples from study group showed significantly higher degree of inflammation than samples from control group (χ 2 =35.89 with p value less than 0.01). Degree of fibrosis in nasal polyposis is in positive correlation with duration of symptoms (r = 0.25, p < 0,05) and with percentage of macrophages in inflammatory infiltrate (r = 0.26, p < 0.05).. Patients with NP had significantly lower number of lymphocytes (r=-7.66, p < 0.01), but significantly higher number of eosinophils (r=3.84, p < 0.01), macrophages (r=3.34, p < 0.01) and plasma cells (r=3.14, p < 0.01) than controls, with p value less than 0.01. Conclusion. Tissue samples from patients with nasal polyposis show significant changes that reflect in various degrees of inflammation, fibrosis and basement membrane thickening which may contribute to more difficult surgical management and perioperative complications such as bleeding.
Nasal cytology: Methodology with application to clinical practice and research
Clinical & Experimental Allergy, 2018
Nasal cytology is an easy, cheap, non-invasive and point-of-care method to assess nasal inflammation and disease-specific cellular features. By means of nasal cytology, it is possible to distinguish between different inflammatory patterns that are typically associated with specific diseases (ie, allergic and non-allergic rhinitis). Its use is particularly relevant when other clinical information, such as signs, symptoms, timecourse and allergic sensitizations, is not enough to recognize which of the different rhinitis phenotypes is involved; for example, it is only by means of nasal cytology that it is possible to distinguish, among the non-allergic rhinitis, those characterized by eosinophilic (NARES), mast cellular (NARMA), mixed eosinophilic-mast cellular (NARESMA) or neutrophilic (NARNE) inflammation. Despite its clinical usefulness, cheapness, non-invasiveness and easiness, nasal cytology is still underused and this is at least partially due to the fact that, as far as now, there is not a consensus or an official recommendation on its methodological issues. We here review the scientific literature about nasal cytology, giving recommendations on how to perform and interpret nasal cytology.
Consensus Document on Nasal Polyposis POLINA PROJECT. SEAIC-SEORL
2011
Nasal polyposis (NP) is a chronic inflammatory disease affecting the nasal mucosa and paranasal sinuses, and which leads to the formation of polyps. The most recent studies suggest NP to be a chronic rhinosinusitis subtype with differential characteristics that could advise a specific diagnostic and therapeutic approach to the disorder. Although the precise prevalence of NP is not known, different epidemiological studies have suggested a fi gure of 2-4%. This indicates that the condition is an important health problem, with a high sociosanitary cost. The management of NP involves the following specialties: Primary Care, Pediatrics, Pneumology, Allergology and Otorhinolaryngology (Ear, Nose and Throat, ENT). For this reason we consider a multidisciplinary approach to be essential for both diagnostic evaluation and treatment strategy of the disease. Two years ago, on occasion of a joint meeting between ENT specialists and allergologists in Lisbon, Antonio Valero (Coordinator of the Rh...