Nasal polyps and sinusitis
R. G. Slavin
Despite the prevalence and long history of nasal polyps, many questions
still exist with respect to incidence and pathogenesis. Although allergy
has been commonly thought to be a major cause, much compelling evidence
argues against this. Medical therapy consists of a short course of systemic
steroids followed by intranasal steroids. Sinusitis is the most commonly
reported chronic disease in the United States. Decrease in ostial size,
retention of secretions, and decrease in mucociliary action all contribute
to the pathogenesis of sinusitis. The clinical presentation of chronic
sinusitis is generally subtle and the clinical index of suspicion must be
high. Limited coronal computed tomography is regarded as the most
definitive and cost-effective imaging technique for the diagnosis of
sinusitis. Appropriate antibiotics must be administered for a sufficient
period. In medically resistant sinusitis, functional endoscopic sinus
surgery has emerged as the procedure of choice.
