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Sinonasal Polyposis
Nicholas A. Koontz, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Sinonasal polyposis (SNP)
            • Synonyms

              • Chronic rhinosinusitis with polyposis (CRSwP)
              • Polyposis nasi; hypertrophic polypoid rhinosinusitis
            • Definitions

              • Nonneoplastic, inflammatory swelling of sinonasal mucosa that buckles to form polyps
              • SNP is general term for nonspecific majority of cases
              • Specific minority forms of CRSwP are classified separately

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Castro A et al: Long term outcomes of balloon sinuplasty for the treatment of chronic rhinosinusitis with and without nasal polyps. Am J Otolaryngol. 42(1):102825, 2021
                                          2. Harrison TW et al: Onset of effect and impact on health-related quality of life, exacerbation rate, lung function, and nasal polyposis symptoms for patients with severe eosinophilic asthma treated with benralizumab (ANDHI): a randomised, controlled, phase 3b trial. Lancet Respir Med. 9(3):260-74, 2021
                                          3. Laidlaw TM et al: Chronic rhinosinusitis with nasal polyps and asthma. J Allergy Clin Immunol Pract. 9(3):1133-41, 2021
                                          4. Chen S et al: Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis. Curr Med Res Opin. 36(11):1913-26, 2020
                                          5. Hussien HA et al: Evaluation of serum total immunoglobulin E, interleukin-17 and pentraxin-3 as biomarkers for chronic rhinosinusitis with nasal polyposis. Am J Rhinol Allergy. 1945892420983787, 2020
                                          6. Hall CA et al: Voice outcomes after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis. Laryngoscope. 129(2):299-302, 2019
                                          7. Le PT et al: Systematic review and meta-analysis of SNOT-22 outcomes after surgery for chronic rhinosinusitis with nasal polyposis. Otolaryngol Head Neck Surg. 159(3):414-23, 2018
                                          8. Gudziol V et al: Olfaction and sinonasal symptoms in patients with CRSwNP and AERD and without AERD: a cross-sectional and longitudinal study. Eur Arch Otorhinolaryngol. 274(3):1487-93, 2017
                                          9. Brescia G et al: A prospective investigation of predictive parameters for post-surgical recurrences in sinonasal polyposis. Eur Arch Otorhinolaryngol. 273(3):655-60, 2016
                                          10. White LC et al: Why sinonasal disease spares the inferior turbinate: An immunohistochemical analysis. Laryngoscope. 126(5):E179-83, 2015
                                          11. Brescia G et al: Can a panel of clinical, laboratory, and pathological variables pinpoint patients with sinonasal polyposis at higher risk of recurrence after surgery? Am J Otolaryngol. 36(4):554-8, 2015
                                          12. Malagutti N et al: Analysis of Il-10 gene sequence in patients with sinonasal polyposis. Int J Immunopathol Pharmacol. 28(3):434-9, 2015
                                          13. Avelino MA et al: The human leukocyte antigen G molecule (HLA-G) expression in patients with nasal polyposis. Braz J Otorhinolaryngol. 80(3):208-12, 2014
                                          14. Rizzo R et al: Infection and HLA-G molecules in nasal polyposis. J Immunol Res. 2014:407430, 2014
                                          15. Hawley KA et al: CT findings of sinonasal respiratory epithelial adenomatoid hamartoma: a closer look at the olfactory clefts. AJNR Am J Neuroradiol. 34(5):1086-90, 2012
                                          16. Siddiqui J et al: Sinonasal bony changes in nasal polyposis: prevalence and relationship to disease severity. J Laryngol Otol. 127(8):755-9, 2013
                                          17. Blomqvist EH et al: A randomized prospective study comparing medical and medical-surgical treatment of nasal polyposis by CT. Acta Otolaryngol. 129(5):545-9, 2009
                                          18. Pearlman AN et al: Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy. Am J Rhinol Allergy. 23(2):145-8, 2009
                                          19. Bonfils P et al: Evaluation of combined medical and surgical treatment in nasal polyposis - III. Correlation between symptoms and CT scores before and after surgery for nasal polyposis. Acta Otolaryngol. 128(3):318-23, 2008
                                          20. Can IH et al: The expression of MMP-2, MMP-7, MMP-9, and TIMP-1 in chronic rhinosinusitis and nasal polyposis. Otolaryngol Head Neck Surg. 139(2):211-5, 2008
                                          21. Corradini C et al: Hyperproliferation in nasal polyposis tissues is not associated with somatic genomic instability. J Otolaryngol Head Neck Surg. 37(4):510-4, 2008
                                          22. Kahveci OK et al: The role of MMP-9 and TIMP-1 in nasal polyp formation. Swiss Med Wkly. 138(45-46):684-8, 2008
                                          23. Mladina R et al: Biofilm in nasal polyps. Rhinology. 46(4):302-7, 2008
                                          24. Mortuaire G et al: Lund-Mackay score is predictive of bleeding in ethmoidectomy for nasal polyposis. Rhinology. 46(4):285-8, 2008
                                          25. Konstantinidis I et al: Olfactory dysfunction in nasal polyposis: correlation with computed tomography findings. ORL J Otorhinolaryngol Relat Spec. 69(4):226-32, 2007
                                          26. Gosepath J et al: Current concepts in therapy of chronic rhinosinusitis and nasal polyposis. ORL J Otorhinolaryngol Relat Spec. 67(3):125-36, 2005
                                          27. Larsen PL et al: Origin of nasal polyps: an endoscopic autopsy study. Laryngoscope. 114(4):710-9, 2004
                                          28. Bateman ND et al: Nasal polyps: still more questions than answers. J Laryngol Otol. 117(1):1-9, 2003
                                          29. Batra PS et al: Outcome analysis of endoscopic sinus surgery in patients with nasal polyps and asthma. Laryngoscope. 113(10):1703-6, 2003
                                          30. Dalziel K et al: Systematic review of endoscopic sinus surgery for nasal polyps. Health Technol Assess. 7(17):iii, 1-159, 2003
                                          31. Pawankar R: Nasal polyposis: an update: editorial review. Curr Opin Allergy Clin Immunol. 3(1):1-6, 2003
                                          32. Bachert C et al: Mediators in nasal polyposis. Curr Allergy Asthma Rep. 2(6):481-7, 2002
                                          33. Blomqvist EH et al: A randomized controlled study evaluating medical treatment versus surgical treatment in addition to medical treatment of nasal polyposis. J Allergy Clin Immunol. 107(2):224-8, 2001
                                          34. Eggesbo HB et al: CT characterization of developmental variations of the paranasal sinuses in cystic fibrosis. Acta Radiol 42:482-93, 2001
                                          35. Eggesbø HB et al: Hypoplasia of the sphenoid sinuses as a diagnostic tool in cystic fibrosis. Acta Radiol. 40(5):479-85, 1999
                                          36. Liang EY et al: Another CT sign of sinonasal polyposis: truncation of the bony middle turbinate. Eur Radiol. 6(4):553-6, 1996
                                          37. Drutman J et al: Sinonasal polyposis: investigation by direct coronal CT. Neuroradiology. 36(6):469-72, 1994
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Sinonasal polyposis (SNP)
                                                    • Synonyms

                                                      • Chronic rhinosinusitis with polyposis (CRSwP)
                                                      • Polyposis nasi; hypertrophic polypoid rhinosinusitis
                                                    • Definitions

                                                      • Nonneoplastic, inflammatory swelling of sinonasal mucosa that buckles to form polyps
                                                      • SNP is general term for nonspecific majority of cases
                                                      • Specific minority forms of CRSwP are classified separately

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Castro A et al: Long term outcomes of balloon sinuplasty for the treatment of chronic rhinosinusitis with and without nasal polyps. Am J Otolaryngol. 42(1):102825, 2021
                                                                                  2. Harrison TW et al: Onset of effect and impact on health-related quality of life, exacerbation rate, lung function, and nasal polyposis symptoms for patients with severe eosinophilic asthma treated with benralizumab (ANDHI): a randomised, controlled, phase 3b trial. Lancet Respir Med. 9(3):260-74, 2021
                                                                                  3. Laidlaw TM et al: Chronic rhinosinusitis with nasal polyps and asthma. J Allergy Clin Immunol Pract. 9(3):1133-41, 2021
                                                                                  4. Chen S et al: Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis. Curr Med Res Opin. 36(11):1913-26, 2020
                                                                                  5. Hussien HA et al: Evaluation of serum total immunoglobulin E, interleukin-17 and pentraxin-3 as biomarkers for chronic rhinosinusitis with nasal polyposis. Am J Rhinol Allergy. 1945892420983787, 2020
                                                                                  6. Hall CA et al: Voice outcomes after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis. Laryngoscope. 129(2):299-302, 2019
                                                                                  7. Le PT et al: Systematic review and meta-analysis of SNOT-22 outcomes after surgery for chronic rhinosinusitis with nasal polyposis. Otolaryngol Head Neck Surg. 159(3):414-23, 2018
                                                                                  8. Gudziol V et al: Olfaction and sinonasal symptoms in patients with CRSwNP and AERD and without AERD: a cross-sectional and longitudinal study. Eur Arch Otorhinolaryngol. 274(3):1487-93, 2017
                                                                                  9. Brescia G et al: A prospective investigation of predictive parameters for post-surgical recurrences in sinonasal polyposis. Eur Arch Otorhinolaryngol. 273(3):655-60, 2016
                                                                                  10. White LC et al: Why sinonasal disease spares the inferior turbinate: An immunohistochemical analysis. Laryngoscope. 126(5):E179-83, 2015
                                                                                  11. Brescia G et al: Can a panel of clinical, laboratory, and pathological variables pinpoint patients with sinonasal polyposis at higher risk of recurrence after surgery? Am J Otolaryngol. 36(4):554-8, 2015
                                                                                  12. Malagutti N et al: Analysis of Il-10 gene sequence in patients with sinonasal polyposis. Int J Immunopathol Pharmacol. 28(3):434-9, 2015
                                                                                  13. Avelino MA et al: The human leukocyte antigen G molecule (HLA-G) expression in patients with nasal polyposis. Braz J Otorhinolaryngol. 80(3):208-12, 2014
                                                                                  14. Rizzo R et al: Infection and HLA-G molecules in nasal polyposis. J Immunol Res. 2014:407430, 2014
                                                                                  15. Hawley KA et al: CT findings of sinonasal respiratory epithelial adenomatoid hamartoma: a closer look at the olfactory clefts. AJNR Am J Neuroradiol. 34(5):1086-90, 2012
                                                                                  16. Siddiqui J et al: Sinonasal bony changes in nasal polyposis: prevalence and relationship to disease severity. J Laryngol Otol. 127(8):755-9, 2013
                                                                                  17. Blomqvist EH et al: A randomized prospective study comparing medical and medical-surgical treatment of nasal polyposis by CT. Acta Otolaryngol. 129(5):545-9, 2009
                                                                                  18. Pearlman AN et al: Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy. Am J Rhinol Allergy. 23(2):145-8, 2009
                                                                                  19. Bonfils P et al: Evaluation of combined medical and surgical treatment in nasal polyposis - III. Correlation between symptoms and CT scores before and after surgery for nasal polyposis. Acta Otolaryngol. 128(3):318-23, 2008
                                                                                  20. Can IH et al: The expression of MMP-2, MMP-7, MMP-9, and TIMP-1 in chronic rhinosinusitis and nasal polyposis. Otolaryngol Head Neck Surg. 139(2):211-5, 2008
                                                                                  21. Corradini C et al: Hyperproliferation in nasal polyposis tissues is not associated with somatic genomic instability. J Otolaryngol Head Neck Surg. 37(4):510-4, 2008
                                                                                  22. Kahveci OK et al: The role of MMP-9 and TIMP-1 in nasal polyp formation. Swiss Med Wkly. 138(45-46):684-8, 2008
                                                                                  23. Mladina R et al: Biofilm in nasal polyps. Rhinology. 46(4):302-7, 2008
                                                                                  24. Mortuaire G et al: Lund-Mackay score is predictive of bleeding in ethmoidectomy for nasal polyposis. Rhinology. 46(4):285-8, 2008
                                                                                  25. Konstantinidis I et al: Olfactory dysfunction in nasal polyposis: correlation with computed tomography findings. ORL J Otorhinolaryngol Relat Spec. 69(4):226-32, 2007
                                                                                  26. Gosepath J et al: Current concepts in therapy of chronic rhinosinusitis and nasal polyposis. ORL J Otorhinolaryngol Relat Spec. 67(3):125-36, 2005
                                                                                  27. Larsen PL et al: Origin of nasal polyps: an endoscopic autopsy study. Laryngoscope. 114(4):710-9, 2004
                                                                                  28. Bateman ND et al: Nasal polyps: still more questions than answers. J Laryngol Otol. 117(1):1-9, 2003
                                                                                  29. Batra PS et al: Outcome analysis of endoscopic sinus surgery in patients with nasal polyps and asthma. Laryngoscope. 113(10):1703-6, 2003
                                                                                  30. Dalziel K et al: Systematic review of endoscopic sinus surgery for nasal polyps. Health Technol Assess. 7(17):iii, 1-159, 2003
                                                                                  31. Pawankar R: Nasal polyposis: an update: editorial review. Curr Opin Allergy Clin Immunol. 3(1):1-6, 2003
                                                                                  32. Bachert C et al: Mediators in nasal polyposis. Curr Allergy Asthma Rep. 2(6):481-7, 2002
                                                                                  33. Blomqvist EH et al: A randomized controlled study evaluating medical treatment versus surgical treatment in addition to medical treatment of nasal polyposis. J Allergy Clin Immunol. 107(2):224-8, 2001
                                                                                  34. Eggesbo HB et al: CT characterization of developmental variations of the paranasal sinuses in cystic fibrosis. Acta Radiol 42:482-93, 2001
                                                                                  35. Eggesbø HB et al: Hypoplasia of the sphenoid sinuses as a diagnostic tool in cystic fibrosis. Acta Radiol. 40(5):479-85, 1999
                                                                                  36. Liang EY et al: Another CT sign of sinonasal polyposis: truncation of the bony middle turbinate. Eur Radiol. 6(4):553-6, 1996
                                                                                  37. Drutman J et al: Sinonasal polyposis: investigation by direct coronal CT. Neuroradiology. 36(6):469-72, 1994