Önerci / Ferguson Nasal Polyposis

Pathogenesis, Medical and Surgical Treatment
1. Auflage 2010
ISBN: 978-3-642-11412-0
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 311 Seiten

Nasal polyposis is seen in many disease states, including allergic and non-allergic rhinitis. Since the quality of life for patients afflicted with this condition decreases, such patients frequently seek medical help. Further, the relationship between the upper and lower respiratory tract makes the treatment of nasal polyposis of critical importance. New research findings, as well as new technical developments, have changed the conventional medical and surgical approaches to treating nasal polyposis, the result of which has been significant advances in the management of the disease. This book, written by authors internationally recognized for their laboratory research and clinical practice, is lavishly illustrated and reader-friendly. It includes the latest information on nasal polyposis, and aims to help the reader improve the daily management of patients affected by this condition.

Autoren/Hrsg.

Önerci, T. Metin

Ferguson, Berrylin J.

Inhaltsverzeichnis

1;Foreword;5
2;Preface;7
3;Contents;9
4;1: History of Nasal Polyposis;12
4.1;1.1 Introduction;12
4.2;1.2 The History of Rhinology and Nasal Polyps;12
4.3;1.3 Etiology and Pathophysiology;12
4.4;1.4 Diagnosis of Nasal Polyps;13
4.5;1.5 Treatment of Nasal polyps;14
4.5.1;1.5.1 Medical Treatment;15
4.5.2;1.5.2 Surgical Treatment;15
4.6;1.6 Conclusions;17
4.7;References;17
5;2: Epidemiology of Nasal Polyps;19
5.1;2.1 Introduction;19
5.2;2.2 Allergy and Asthma;20
5.3;2.3 Gender and Age;21
5.4;2.4 Genetics;21
5.5;2.5 Aspirin Intolerance;22
5.6;2.6 Allergic Fungal Rhinosinusitis;22
5.7;2.7 Ethnicity and Geography;23
5.8;References;24
6;3: Pathology of Nasal Polyps;26
6.1;3.1 Introduction;26
6.2;3.2 Normal Sinonasal Histology;26
6.2.1;3.2.1 Structural Component;26
6.2.2;3.2.2 Nonstructural Components;28
6.3;3.3 Nasal Polyp Histopathology;29
6.3.1;3.3.1 Chronic Rhinosinusitis with Nasal Polyps;29
6.3.1.1;3.3.1.1 Macroscopic Pathology;29
6.3.1.2;3.3.1.2 Microscopic Pathology;30
6.3.2;3.3.2 Bone Changes;32
6.3.3;3.3.3 Mucus Histopathology, Including “Eosinophilic Mucus”;32
6.3.4;3.3.4 Antrochoanal Polyps;32
6.3.5;3.3.5 Noninflammatory Polypoid Lesions;33
6.4;3.4 Conclusions;34
6.5;References;34
7;4: The Inflammatory Process in Nasal Polyposis: Genetics, Molecular Biology, and Electrophysiology;36
7.1;4.1 The Nasal Polyp Represents an End-Stage of Chronic Inflammation;36
7.2;4.2 Genetic Predisposition and Staphylococcal Enterotoxins as Two Predisposing Factors in the Development of Chronic Hyper;37
7.3;4.3 Cytokines in the Nasal Polyp Mucosa;37
7.4;4.4 TNF-a and VCAM 1;38
7.5;4.5 The Eosinophil and Alterations in the Electrophysiology of the Nasal Epithelial Cell; Sodium Channel Alterations;40
7.6;4.6 Summary;41
7.7;References;42
8; 5: Eosinophil;44
8.1;5.1 Introduction;44
8.2;5.2 Pathogenesis: The Role of the Eosinophil;44
8.2.1;5.2.1 Development of Eosinophils;44
8.3;5.3 Trafficking of Eosinophils;45
8.3.1;5.3.1 Recruitment;45
8.3.2;5.3.2 Adhesion;45
8.3.3;5.3.3 Activation of Eosinophils;46
8.3.4;5.3.4 Eosinophil Secretory Products;46
8.4;5.4 Pharmacological Approaches to Treating Eosinophilic Sinusitis;49
8.5;5.5 Conclusion;50
8.5.1;Take Home Pearls;50
8.6;References;51
9; 6: Radiologic Imaging of Nasal Polyposis;53
9.1;6.1 Introduction;53
9.2;6.2 Radiologic Appearance of Sinonasal Polyps;53
9.3;6.3 Special Types of Sinonasal Polyps;55
9.4;6.4 Complications;56
9.5;6.5 Radiologic Differential Diagnosis;58
9.5.1;6.5.1 Acute Rhinosinusitis;58
9.5.2;6.5.2 Mucus Retention Cyst;58
9.5.3;6.5.3 Other Benign Masses;58
9.5.4;6.5.4 Malignancy;59
9.5.5;6.5.5 Dense Secretions;59
9.5.6;6.5.6 Cystic Fibrosis;59
9.6;6.6 Radiologic Modalities;60
9.6.1;Take Home Pearls;60
9.7;References;60
10; 7: Pathogenesis and Pathophysiology of Nasal Polyps;61
10.1;7.1 Introduction;61
10.2;7.2 Adenoma and Fibroma theory;61
10.3;7.3 Necrotizing Ethmoiditis Theory;61
10.4;7.4 Glandular-Cyst Theory;62
10.5;7.5 Mucosal Exudate Theory;62
10.6;7.6 Theory on Cystic Dilatation of the Excretory Duct of Nasal Glands and Vessel Obstruction;64
10.7;7.7 Blockade Theory;64
10.8;7.8 Peri-Phlebitis and Peri-Lymphangitis Theory;64
10.9;7.9 Glandular Hyperplasia Theory;64
10.10;7.10 Epithelial Rupture Theory;65
10.11;7.11 Mucous Glands in Nasal Polyps;65
10.12;7.12 Formation and Growth of Glands;67
10.13;7.13 Gland Degeneration;67
10.14;7.14 Cellular Infiltration in the Pathophysiology of Nasal Polyps;68
10.15;References;71
11;8: Mucin Expression in Nasal Polyps;72
11.1;8.1 Introduction;72
11.2;8.2 Mucin Genes;72
11.3;8.3 Sources of Mucus Hyper-Secretion in Nasal Polyps;73
11.4;8.4 Studies of Mucin Gene Expression in Nasal Polyps;73
11.4.1;8.4.1 Techniques;73
11.4.2;8.4.2 Control Mucosa for Mucin Gene Studies in Nasal Polyps;73
11.4.3;8.4.3 Main Studies;74
11.5;8.5 Mucin Gene Expression in Nasal Polyps;74
11.5.1;8.5.1 General Mucin Gene Expression Profile;74
11.5.2;8.5.2 Individual Mucin Genes;76
11.5.2.1;8.5.2.1 MUC1;76
11.5.2.2;8.5.2.2 MUC2;76
11.5.2.3;8.5.2.3 MUC3 and 6;76
11.5.2.4;8.5.2.4 MUC4;76
11.5.2.5;8.5.2.5 MUC5AC;77
11.5.2.6;8.5.2.6 MUC5B and 7;77
11.5.2.7;8.5.2.7 MUC8;77
11.6;8.6 Steroids and Mucin Expression in Nasal Polyps;77
11.7;8.7 Discussion;78
11.8;8.8 Future Work;78
11.9;References;78
12;9: Biofilms;81
12.1;9.1 Introduction;81
12.2;9.2 What is a Biofilm?;81
12.3;9.3 Biofilms and Chronic Rhinosinusitis: What is the Evidence?;82
12.4;9.4 Chronic Biofilm Diseases;83
12.5;9.5 Pathophysiology;83
12.6;9.6 Antibiotic Resistance;84
12.7;9.7 Mucociliary Clearance Effects;85
12.8;9.8 Treatments;85
12.9;9.9 Conclusions;86
12.10;References;86
13;10: Staphylococcus-aureus.-derived Superantigens in Nasal Polyp Disease;88
13.1;10.1 Introduction;88
13.2;10.2 Superantigenic Properties of Staphylococcus aureus Enterotoxins;89
13.3;10.3 Invasion of Nasal Tissue by Staphylococcus aureus;91
13.4;10.4 Augmented Immune Response to SAE in Polyps;92
13.5;10.5 Mechanisms Leading to Polyps;93
13.6;10.6 Relation to Eicosanoid Metabolism and Aspirin Sensitivity;95
13.7;10.7 Clinical Implications;96
13.8;10.8 Summary and Perspectives;97
13.9;References;98
14;11: Fungal-Induced Inflammation and Nasal Polyps;100
14.1;11.1 Introduction;100
14.2;11.2 Fungus Is Among Us;100
14.3;11.3 The Immune Response to Fungi;101
14.4;11.4 The Destructive Power of Eosinophils;102
14.5;11.5 An Immunologic Defense?;103
14.6;11.6 Alternaria-Induced Eosinophil Degranulation;103
14.7;References;105
15;12: Categorization of Nasal Polyps;107
15.1;12.1 Symptom Scores;107
15.2;12.2 CT Imaging Categorization;109
15.3;12.3 Endoscopic Scoring;110
15.4;12.4 Specific Nasal Polyp Scoring;110
15.5;12.5 Objective Measures of Nasal Function for Categorization;111
15.6;12.6 Histologic Categorization;112
15.7;12.7 Presence of Bacteria or Fungus;112
15.8;12.8 Categorization by Disease Severity and Medication Requirements;112
15.9;References;114
16;13: Nasal Polyps and Lower Respiratory Tract Relationship;115
16.1;13.1 Introduction;115
16.2;13.2 Prevalence of Nasal Polyps in Diseases of Lower Respiratory Tract;115
16.3;13.3 Link Between Nasal Polyps and Lower Airways;116
16.4;13.4 Inflammatory Mechanisms of NP in Diseases Other than Bronchial Asthma;116
16.5;13.5 Inflammatory Mechanisms in NP and Bronchial Asthma;116
16.6;13.6 The Role of Cysteinyl Leukotrienes in Nasal Polyps and Bronchial Asthma;117
16.7;13.7 The Role of Microorganisms in Nasal Polyps and Bronchial Asthma;117
16.8;13.8 Effect of Nasal Polyps on Bronchial Hyperreactivity;117
16.9;13.9 Effect of Sinus Surgery on Clinical and Therapeutic Outcomes of Bronchial Asthma;118
16.10;13.10 Effect of Pharmacotherapy of Nasal Polyps on Bronchial Asthma;118
16.10.1;13.10.1 Corticosteroids;118
16.10.2;13.10.2 Leukotriene Inhibitors;119
16.10.3;13.10.3 Zileuton;119
16.10.4;13.10.4 Leukotriene Receptor Antagonists;119
16.10.5;13.10.5 Aspirin Desensitization;119
16.10.6;13.10.6 Other Agents;119
16.11;References;120
17;14: Nasal Polyp, Analgesic Intolerance, and Bronchial Hyperreactivity;123
17.1;14.1 Introduction;123
17.2;14.2 Histopathology;124
17.3;14.3 Bronchial Hyperreactivity, Bronchial Asthma, and Aspirin-Induced Asthma;125
17.4;14.4 Clinical Features, Associated Conditions, and Quality of Life;126
17.5;14.5 Diagnosis of AI and BHR;127
17.6;14.6 Treatment;128
17.7;References;128
18;15: Allergic Fungal Sinusitis;131
18.1;15.1 Introduction/History;131
18.2;15.2 Epidemiology and Microbiology;132
18.3;15.3 Clinical Presentation;132
18.4;Diagnostic Criteria for AFS;132
18.5;15.4 Diagnostic Criteria;133
18.6;Imaging Findings in AFS;134
18.7;15.5 Radiologic Features;134
18.8;15.6 Pathophysiology;136
18.9;Treatment of AFS;136
18.10;15.7 Treatment;136
18.11;15.8 Natural Course;138
18.11.1;Take Home Pearls;138
18.12;References;138
19;16: Vasculitis Including Churg–Strauss Syndrome;140
19.1;16.1 Introduction;140
19.2;16.2 Vasculitic Diseases;140
19.2.1;16.2.1 Wegener’s Granulomatosis;140
19.2.2;16.2.2 Churg–Strauss Syndrome;143
19.2.3;16.2.3 Microscopic Polyangiitis;143
19.2.4;16.2.4 Polyarteritis Nodosa;144
19.2.5;16.2.5 Cryoglobulinemic Vasculitis;144
19.2.6;Take Home Pearls;145
19.3;References;145
20;17: Nasal Polyps in Cystic Fibrosis;147
20.1;17.1 Introduction;147
20.2;17.2 Epidemiology of Sinonasal Disease in Cystic Fibrosis;147
20.3;17.3 Etiology;147
20.3.1;17.3.1 Genetics;147
20.3.2;17.3.2 Pseudomonas Colonization;148
20.3.3;17.3.3 Allergy;148
20.4;17.4 Pathology;148
20.5;17.5 Clinical Presentation;149
20.6;17.6 Investigations;149
20.6.1;17.6.1 Radiology;149
20.6.2;17.6.2 Microbiology;150
20.7;17.7 Management;150
20.7.1;17.7.1 Medical;150
20.7.2;17.7.2 Surgery;150
20.7.2.1;17.7.2.1 Extent of Surgery;151
20.7.3;17.7.3 Novel Treatments;151
20.7.3.1;17.7.3.1 Dornase Alfa;151
20.7.3.2;17.7.3.2 Ibuprofen;151
20.7.3.3;17.7.3.3 Antibiofilm Therapies;152
20.7.4;17.7.4 Management of Nasal Polyps Prior to Lung Transplantation;152
20.8;17.8 .Conclusion;152
20.9;References;152
21;18: Nasal Polyposis in Children: A Differential Diagnosis and Algorithm;155
21.1;18.1 Introduction;155
21.2;18.2 Antrochoanal Polyp;155
21.3;18.3 Cystic Fibrosis;156
21.4;18.4 Encephaloceles or Meningoencephalocele;158
21.5;18.5 Idiopathic Nasal Polyposis;158
21.6;18.6 Primary Ciliary Dyskinesia (PCD);159
21.7;18.7 Saccharin Test;159
21.8;18.8 Ciliary Beat Frequency;159
21.9;18.9 Electron Microscopy;159
21.10;18.10 Immunodeficiency;160
21.11;18.11 Allergic Aspergillosis;161
21.12;18.12 Tumours;162
21.13;References;162
22;19: Olfaction and Nasal Polyposis;165
22.1;19.1 Introduction;165
22.1.1;19.1.1 Bullet Messages;166
22.2;19.2 Impaired Olfaction: An Important Primary Symptom in CRS with Nasal Polyposis;166
22.3;19.3 Clinical Olfactory Testing;166
22.4;19.4 Taste and Smell;166
22.5;19.5 Subjective Test Methods;167
22.6;19.6 Trigeminal Nerve Assessment;169
22.7;19.7 Objective Test Methods;169
22.7.1;19.7.1 Bullet Messages;170
22.8;19.8 Nasal Airflow Patterns and Olfaction;170
22.8.1;19.8.1 Bullet Messages;170
22.9;19.9 Location of the Olfactory Epithelium;170
22.9.1;19.9.1 Bullet Messages;171
22.10;19.10 The Medical Management of Disordered Smell in CRS with Nasal Polyposis;171
22.11;19.11 Sinus Surgery and Olfaction in CRS with Nasal Polyposis;172
22.12;19.12 Tailor the Surgery to the Extent of the Problem;172
22.12.1;19.12.1 Bullet Messages;172
22.13;19.13 Impact of Endoscopic Sinus Surgery on Olfactory Function in CRS with Nasal Polyposis;173
22.13.1;19.13.1 Bullet Messages;173
22.14;19.14 Conclusions and Perspectives;173
22.15;References;174
23;20: New Areas for Investigation: Nitric Oxide;176
23.1;20.1 Introduction;176
23.2;20.2 Nitric Oxide Synthesis and Metabolism;176
23.3;20.3 Biological Activities;178
23.4;20.4 Considerations of Nitric Oxide Measurement;178
23.5;20.5 Nitric Oxide in Airway Physiology;179
23.6;20.6 Nitric Oxide in Chronic Airway Inflammatory Diseases;180
23.6.1;20.6.1 Primary Ciliary Dyskinesia;180
23.6.2;20.6.2 Cystic Fibrosis;180
23.6.3;20.6.3 Allergic Rhinitis;180
23.6.4;20.6.4 Chronic Rhinosinusitis with and Without Nasal Polyposis;181
23.7;20.7 Future Perspectives;182
23.8;References;182
24;21: Current Concepts on the Pathomechanisms of Chronic Rhinosinusitis and Nasal Polyps;185
24.1;21.1 Introduction;185
24.2;21.2 Etiology;185
24.3;21.3 Inflammatory Mechanisms in CRS and Nasal Polyps;186
24.4;21.4 Remodeling in CRS and NP;187
24.5;21.5 Conclusion;188
24.6;References;188
25;22: Relapses After Surgery and Their Prevention;191
25.1;22.1 Introduction;192
25.2;22.2 Clinical Prevention;193
25.3;22.3 Prevention of Eosinophilic Inflammation;193
25.4;22.4 Prevention of Changes in Arachidonic Acid Metabolism;194
25.5;22.5 Prevention of Edema Formation;194
25.6;22.6 Prevention of Tissue Growth/Remodeling;195
25.7;22.7 Antimicrobial Prevention;195
25.8;22.8 Antifungal Prevention;196
25.9;References;197
26;23: Cortison Therapy in Nasal Polyposis;199
26.1;23.1 Introduction;199
26.2;23.2 Intranasal Steroids (INS);200
26.2.1;23.2.1 Postoperative Use of Topical Corticosteroids;201
26.2.2;23.2.2 Side Effects of Intranasal Steroids;202
26.2.3;23.2.3 Oral Corticosteroids and Maximal Medical Therapy;203
26.3;23.3 Perioperative Use of Oral Corticosteroids;203
26.3.1;23.3.1 Allergic Fungal Sinusitis;203
26.4;23.4 Risks and Side Effects of Oral Corticosteroids;204
26.4.1;23.4.1 Risks of Corticosteroids;204
26.4.2;23.4.2 Risks of Intrapolyp Injection;204
26.5;References;205
27;24: Antifungal Treatment (Topical/Systemic);207
27.1;24.1 Introduction;207
27.2;24.2 Topical Antimycotics: An Open Debate;208
27.3;24.3 Systemic Oral Antimycotics;212
27.4;24.4 Antimycotics After Endoscopic Sinus Surgery;212
27.5;24.5 Effects of Amphotericin B;212
27.6;24.6 Side Effects of Antimycotics;213
27.7;24.7 Conclusions;214
27.8;References;215
28;25: Antibiotic Treatment (Topical/Systemic);217
28.1;25.1 Background;217
28.2;25.2 Potential Therapeutic Actions of Antibiotic Agents;218
28.3;25.3 Topical Intranasal Antibiotic Agents (Table 25.1);224
28.4;25.4 Systemic Antibiotic Agents;224
28.4.1;25.4.1 Does Short-Term Antibiotic Treatment Confer a Benefit? (Table 25.2);225
28.4.2;25.4.2 How Do Different Antibiotics Compare? (Table 25.2);225
28.4.3;25.4.3 Does Long-Term Macrolide Treatment Confer a Benefit? (Table 25.3);225
28.5;25.5 Antibiotic Agents After Endoscopic Sinus Surgery (Table 25.3);227
28.6;25.6 Side Effects of Antibiotic Agents;227
28.7;25.7 Conclusions;228
28.8;References;228
29;26: Aspirin Intolerance;231
29.1;26.1 Introduction;231
29.2;26.2 Postoperative Care and Long-Term Medical Management to Prevent Recurrence;232
29.3;26.3 Characteristics of Aspirin Intolerance in Polypous CRS;232
29.3.1;26.3.1 Role of an In Vitro Assay;233
29.4;26.4 Aspirin Desensitization;234
29.5;26.5 Implications of Eicosanoid Imbalance on the Pathophysiology of Nasal Polyps;235
29.6;26.6 Conclusion;236
29.7;References;236
30;27: Where Are We in the Medical Treatment of Nasal Polyps;238
30.1;27.1 Introduction;238
30.1.1;27.1.1 Treatment of Nasal Polyposis with Corticosteroids;238
30.1.1.1;27.1.1.1 Systemic Corticosteroids;242
30.1.2;27.1.2 Treatment of Nasal Polyps with Antibiotics;242
30.1.3;27.1.3 Other Medical Management for Nasal Polyposis;243
30.2;27.2 Conclusion;245
30.3;References;245
31;28: Anesthetic Management in Nasal Polypectomy;248
31.1;28.1 Anesthetic Management;249
31.2;References;251
32;29: Surgical Treatment of Nasal Polyposis;252
32.1;29.1 Introduction;252
32.2;29.2 Pathogenesis;252
32.2.1;29.2.1 Nasal Polyps;252
32.2.2;29.2.2 Antrochoanal Polyps;253
32.3;29.3 Examination;254
32.4;29.4 Imaging Studies;255
32.4.1;29.4.1 Computed Tomography;255
32.4.2;29.4.2 Magnetic Resonance Imaging;257
32.5;29.5 Surgical Therapy;257
32.5.1;29.5.1 General Principles;257
32.5.2;29.5.2 Functional Endoscopic Sinus Surgery;258
32.5.3;29.5.3 Image-Guided Surgery;259
32.5.4;29.5.4 Surgical Steps;259
32.6;29.6 Postoperative Management;261
32.6.1;29.6.1 Steroid Injection;262
32.7;29.7 Conclusions;262
32.8;References;263
33;30: Nasalisation in the Surgical Treatment of Nasal Polyposis;264
33.1;30.1 Introduction;265
33.2;30.2 Philosophy of the Nasalisation Surgical Procedure;265
33.3;30.3 Nasalisation Technique;266
33.3.1;30.3.1 Anatomical Considerations;266
33.3.2;30.3.2 Set-Up;267
33.3.3;30.3.3 Surgical Dissection (Video);267
33.3.4;30.3.4 Post-Operative Care;269
33.4;30.4 Results;269
33.5;30.5 Discussion: Controlling the Underlying Pathophysiological Mechanism;272
33.6;References;273
34;31: Reasons for Failure and Complications of Surgery in Diffuse Nasal Polyposis;274
34.1;31.1 Postoperative Care;281
34.2;31.2 Nasal Polyposis in Children;281
34.3;31.3 Complications;282
34.4;31.4 Conclusion;286
34.5;References;286
35;32: Nasal Polyposis: Aggressive Sinus Marsupialization Including the Endoscopic Modified Lothrop Procedure;288
35.1;32.1 Introduction;288
35.2;32.2 Polypoid Chronic Rhinosinusitis with a Poor Surgical Prognosis;288
35.3;32.3 Rationale for the EMLP or Frontal Drillout;289
35.4;32.4 Surgical Plan and Surgical Technique;290
35.5;32.5 Conclusion;294
35.5.1;Take Home Pearls;295
35.6;References;295
36;33: Evaluation of Surgical Treatments;296
36.1;33.1 Introduction;296
36.2;33.2 Evidence-Based Surgical Treatment of Nasal Polyps;296
36.3;33.3 How Do We Measure the Efficacy of Sinus Surgery;297
36.4;33.4 Can We Predict the Outcomes of Sinus Surgery;297
36.5;33.5 Predictors of Outcomes of FESS in CRS with NP;298
36.6;33.6 Surgery as Part of Treatment of Nasal Polyps;299
36.7;33.7 Functional Endoscopic Sinus Surgery in Nasal Polyps;299
36.7.1;33.7.1 Conclusion;299
36.8;33.8 Functional Endoscopic Sinus Surgery vs. Conventional Surgery;299
36.8.1;33.8.1 Conclusion;300
36.9;33.9 Extent of Surgery;300
36.9.1;33.9.1 Conclusion;300
36.10;33.10 Revision Sinus Surgery;300
36.10.1;33.10.1 Conclusion;301
36.11;References;301
37;Index;304