Sunday, May 29, 2011

Nasal polyps

Nasal polyps
Nasal polyps are a growth of nasal mucous membranes that are benign.
The cause of polyps is unknown, but some polyps grow because of the swelling due to infection.

Polyps are often found in people:
Allergic rhinitis
Chronic Sinusitis
Cystic fibrosis.
Polyps are usually grown in areas where the mucous membrane to swell due to fluid retention, such as the area around the hole in the nasal sinuses.
When newly formed, a polyp looks like a tear and if it has matured, its shape resembles grapes grayish.

Cause blockage of nasal polyps, so patients often complain of decreased sense of smell functions.
Because the sense of taste associated with the sense of smell, then the person may also experience decreased function of the sense of taste and smell.

Nasal polyps can also cause blockage of the drainage of mucus from the sinuses to the nose. This blockage causes buried mucus in the sinuses. Mucus that is too long in the sinuses can become infected and eventually sinusitis.

People with children often nasal voice and breathe through his mouth.
Diagnosis is based on symptoms and physical examination.
Drugs containing a corticosteroid nasal spray can sometimes reduce the size of the polyp or even remove polyps.

Surgery is done if:
Polyps obstruct the respiratory tract
Polyps obstruct the sinus drainage from sinus infections that often occur
Polyps associated with tumors.

Polyps tend to grow back if the cause (allergy or infection) was not controlled.
Use of nasal spray containing corticosteroids can slow or prevent recurrence. But if the recurrence was severe in nature, should do the surgery to improve sinus drainage and dispose of infected materials.

If you experience persistent nasal congestion and more and more weight coupled with the always dripping snot and disorders of smell functions, chances are you suffer from nasal polyps. Nasal polyps occur because of the emergence of soft tissue in the nasal cavity of the white or gray. This network can be observed directly with the naked eye after enlarged nostrils with nasal speculum tool.

Nasal polyps usually affects adults probably caused by hypersensitivity reactions or allergic reactions in the nasal mucosa that persists. Some other factors that increase the likelihood of nasal polyps include sinusitis (sinus inflammation), which have chronic irritation, nasal obstruction because of anatomical abnormalities and the enlargement in Konka.

The principle of treatment of nasal polyps is overcome polip and avoid the causes or factors that promote the occurrence of polyps. If a small polyp treatment with oral drugs and nasal sprays with the spray. However, when large polyps and no treatment is possible with oral or spray the surgical removal of polyps should be performed.

Unfortunately if the factors that caused the polyp is not resolved then it prone to nasal polyp recurrence thus repeated. Therefore, patient compliance is expected to avoid things that cause allergies which can lead to the occurrence of nasal polyps.

Nasal polyps is a disorder of the nose and paranasal sinus mucosa especially osteomeatal complex (OMC) in the meatus nasi medius stemmed form a soft mass, shape round or oval, grayish white. Its surface is smooth and somewhat translucent because many contain fluid. Often bilateral and multiple. Polyp is a manifestation of various diseases and is often associated with sinusitis, allergic rhinitis, asthma, and others.
Etiology of nasal polyps
Etiology of nasal polyps is not known with certainty. But there are 3 factors that play a role in the occurrence of polyps rice, namely:
1. Inflammation. Inflammation of the nose and paranasal sinus mucosa of chronic and recurrent.
2. Vasomotor. Impaired vasomotor balance.
3. Edema. Increased interstitial fluid pressure causing edema of the nasal mucosa.
This edema can be explained by the Bernoulli phenomenon.
This phenomenon is an explanation of Bernoulli's law of the laws of air flowing through narrow places will cause negative pressure on the surrounding area so that the network of weak ties will be sucked by the negative pressure. As a result there arose this mukosa.Circumstances edema continues until there was a nasal polyp. There is also a form of variations of nasal polyps
koana called polyps (polyps koana antrum). koana polyps (polyps koana antrum) is a large polyp in the nasopharynx and maxillary sinus originating from the antrum. Polyps are out through the ostium and maxillary sinus ostium and accessories into the nasal cavity and then continue to the koana and enlarged in the nasopharynx.

Diagnosis of nasal polyps

How to diagnose nasal polyps, namely:
1. Anamnesis.
2. Physical examination. Visible external nasal deformity.
3. Rinoskopi anterior. Easy to see polyps that have been entered into the nasal cavity.
4. Endoscopy. To view the polyps are still small and not yet out of the complex osteomeatal.
5. Plain X-rays and CT-scan. To detect sinusitis.
6. Biopsy. We recommend that if there is a unilateral mass in elderly patients, resembling malignancy on macroscopic appearance and there is a picture of bone erosion on plain x-ray images.
Anamnesis for the diagnosis of nasal polyps:
1. Nasal congestion.
2. There was a mass in the nose.
3. Difficult to blow her nose.
4. Olfactory disorders: anosmia & hiposmia.
5. Secondary symptoms. When accompanied by abnormalities in the surrounding tissues and organs such as post nasal drip, headache, face pain, nasal voice (bindeng), the ear feeling full, snoring, sleep disturbance and decreased quality of life.
Therapy nasal polyps
There are 3 kinds of therapeutic nasal polyps, namely:
1. Medical: corticosteroids, antibiotics and anti-allergic.
2. Operation: polipektomi & etmoidektomi.
3. Combination: medical & surgery.
Give corticosteroids in polyp is still small and not yet entered the nasal cavity. It can be systemic, intranasal, or a combination of both. Use of high dose systemic corticosteroids and a short time. Give antibiotics if there are signs of infection. Give anti-allergy if the trigger is considered an act of removal of polyps alergi. Polipektomi using a string of polyps with the aid of local anesthesia. Category polyps are removed is a large polyp but have not packed the nasal cavity. Etmoidektomi or functional endoscopic sinus surgery (BSEF / FESS) is the act of removal of polyps as well as sinus surgery. Criteria polyp is a polyp is removed a very large, repetitive, and there are clear abnormalities in the complex osteomeatal. Antibiotics as combination therapy in nasal polyps can we give before and after operation. Give antibiotics if there are signs of infection and for post-operative prophylactic measures.


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