nasal polyps
Introduction
Nasal polyps Nasal polyps are common diseases of the nose and are also associated with certain systemic diseases. It is the result of tissue edema caused by a long-term inflammatory reaction of the nasal mucosa. Most of the nasal polyps are derived from the sinus ostium of the middle nasal passage, the nasal passage complex and the ethmoid sinus. The highly edematous nasal mucosa swells from the middle nasal passage and the sinus ostium to the nasal cavity to form polyps. Due to the multiplicity of the cause and obvious postoperative operation Recurrence tends to occupy an important position in nasal diseases. The cause of the disease is still unclear. It is believed that chronic infection of the upper respiratory tract and allergic reactions are the main causes of nasal polyps. The stimulation of the reactive inflammatory reaction causes the macrophages in the mucosa to release IGF-I and accumulate in the mucosa, which can stimulate the mucosal proliferation for a long time. When the proliferating mucosa fills the sinus cavity, it protrudes into the nasal cavity from the sinus ostium. Long-term growth stimuli and local inflammatory reactions are important factors leading to the formation of polyps. basic knowledge The proportion of sickness: 0.4% Susceptible people: no specific people Mode of infection: non-infectious Complications: rhinitis
Cause
Cause of nasal polyps
Cause:
The cause of the disease is still unclear. It is believed that chronic infection of the upper respiratory tract and allergic reactions are the main causes of nasal polyps. The stimulation of the reactive inflammatory reaction causes the macrophages in the mucosa to release IGF-I and accumulate in the mucosa, which can stimulate the mucosal proliferation for a long time. When the proliferating mucosa fills the sinus cavity, it protrudes into the nasal cavity from the sinus ostium. Long-term growth stimuli and local inflammatory reactions are important factors leading to the formation of polyps.
Prevention
Nasal polyps prevention
1. Most of the diseases are secondary diseases or complications of various nasal diseases, so it is necessary to actively treat various primary nasal diseases.
2. The working and living environment should keep the air fresh.
3, usually in the nasal cavity with less mint, borneol preparation.
4, avoid spicy food, alcohol and other irritating foods.
5, nasal cleaning interventional therapy.
6, patients should remember the time of the follow-up. Don't decide not to review because you feel like you are healed. Any follow-up review after surgery is very important.
7, pay attention to diet after surgery. Patients should eat some high-protein, high-calorie, vitamin-rich liquid food and semi-liquid food after surgery to increase the patient's own body resistance and prevent infection. In addition, the diet should avoid overheating and hard food, so as not to damage the mucous membrane and cause wound bleeding.
8, pay attention to rest position. The patient's correct position after sleep and rest plays an important role in postoperative recovery. For example, taking a semi-recumbent position can reduce head congestion, hemorrhage, and facilitate discharge of secretions to reduce local swelling.
Complication
Nasal polyps complications Complications rhinitis
A small number of large polyps can still cause invasive complications, rapid growth, large polyps, can be destroyed by mechanical compression of the sinus wall or the nasal wall, followed by invasion of the eyelids, frontal sinus, anterior cranial fossa, sphenoid sinus And the middle cranial fossa.
Symptom
Symptoms of nasal polyps Common symptoms Squamous epithelium repeatedly infected with frog-shaped nasal paralysis secondary to purulent secretions. Intranasal nasal insufficiency, nasal congestion, dyspnea, pulmonary fibrosis
1. Persistent nasal congestion, decreased sense of smell, occlusive nasal sounds, sleep snoring and mouth breathing.
2. There may be hooliganism, headache, tinnitus, ear nausea and hearing loss.
3. Mucinous polyps, similar to peeling grape-like or fresh lychee meat, smooth and translucent surface, pink, with fine bands from the middle nasal passages, soft touch.
4. Hemorrhagic polyps (less) have a smooth surface, congestion, soft touch and easy bleeding.
5. Fibrous polyps are grayish white, the surface is smooth, and it is not easy to bleed when touched.
6. Multiple polyps often come from the ethmoid sinus. A single polyp grows from the maxillary sinus. After the fall, the nostrils are called "post-nasal polyps.
7. Nasal polyps increase and become large, long-term treatment, can cause the nose to widen to form a "frog nose."
Examine
Nasal polyp examination
The anterior endoscopic examination revealed one or more smooth, grayish-white or reddish-colored, translucent new organisms in the nasal cavity, such as fresh lychee-like or peeled grape-like or water-storage rubber bags, which are soft and movable when palpated. It is not easy to bleed and does not feel pain. According to the above typical findings, the diagnosis is easy. The posterior nostril polyps are sometimes difficult to see through the anterior nares. The nasal mucosa must be contracted before the examination, and the nasal endoscopy, nasal endoscopy and X Line sinus radiographs can identify the location and extent of the lesion.
Diagnosis
Diagnosis and identification of nasal polyps
Most of the nasal polyps are bilateral. If a polypoid mass is found on one side, the following diseases should be noted:
1. The maxillary sinus polypoid polyps are more common in adolescents. The anterior or nasal fiber endoscopy shows that the gray-white smooth stem pedicle extends from the front end of the middle nasal passage to the posterior nostril. The posterior nasal cavity can be seen in the posterior nostril. Can protrude into the nasopharyngeal cavity or even the oropharynx.
2. Nasal septal hemorrhagic polyps are more common in young people. The masses occur mostly in the septum, dark red, single hair and small volume, easy to hemorrhage. Patients often have a history of nasal discharge, which is generally considered to be hematopoietic cell residue during embryonic process. Caused.
3. Inverted papilloma often has a history of epistaxis or blood stasis, the tumor is red or grayish red, the surface is not smooth, the small size is similar to polyps, but the bleeding is more when the polyp is removed, and it is easy to bleed when it is touched. Finally Diagnosis should be pathologically examined.
4. The intranasal malignant tumor is dark red, the bleeding is easy to touch, the surface is uneven, the nasal odor is obvious, and the patient is more than middle-aged.
5. Intranasal meningeal bulging mass is mostly located at the top of the nasal cavity, the surface is smooth, pink, the nasal congestion is not obvious, the history is long and the progress is slow, more common in children and adolescents.
6. Other rare intracranial masses protrude into the nasal cavity such as chordoma, neuroblastoma, pituitary tumor and so on.
In addition, elderly patients with multiple history of nasal polyps should pay attention to the possibility of malignant changes, especially those with more intraoperative bleeding.
X-ray films of patients with nasal polyps showed uniform cloud-like opacity of the ethmoid sinus, thickening of the maxillary sinus mucosa and sometimes small semicircular shadows, suggesting mucosal polyps in the sinus cavity. X-ray films are characterized by proliferative sinusitis. Performance, such as secondary infection, is shown as a sign of purulent sinusitis.
