Polyp

Expression and clinical significance of PLUNC protein in nasal polyp and chronic sinusitis tissue

July 5, 2012     Min-man Wu, MD; Hong Sun, MD, PhD; Qiong Nan, MD
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Abstract

We conducted a study to validate the expression of PLUNC (palate, lung, and nasal epithelial clone) protein in nasal polyp and chronic sinusitis tissue by immunohistochemistry. We also explored the relationship between the intensity of positive immunohistochemical staining for PLUNC protein and postoperative therapeutic efficacy. Our study population consisted of 34 patients with nasal polyps and 30 with chronic sinusitis who had undergone surgical treatment, along with 18 healthy controls who did not undergo surgery. All samples were stained according to the streptavidin-peroxidase immunohistochemical method to examine PLUNC protein expression. The surgical patients were evaluated for clinical therapeutic efficacy 6 months postoperatively. The association between efficacy and the intensity of PLUNC protein positivity was examined by the Spearman rank correlation analysis. Intensity was rated as either +++(>50% positive cells), ++ (26 to 50% positive cells),+ (≤25% positive cells), or(no positive cells). We found that the most common levels of PLUNC positivity were + in the patients with nasal polyps, +++ in the patients with chronic sinusitis, and ++ in the controls (p< 0.01). Analysis of the Spearman rank correlation indicated that the intensity of PLUNC protein expression was significantly correlated with postoperative therapeutic efficacy (p< 0.001). We conclude that PLUNC protein is an essential factor in the innate defense mechanism of the nasal mucosa. The immunohistochemical staining of PLUNC protein could have clinical benefit in terms of predicting therapeutic efficacy and outcomes in patients with nasal polyps or chronic sinusitis.

Lymphangiomatous polyp of the nasal cavity: A rare presentation

April 30, 2012     Subhash C. Gupta, MS; Sachin Jain, MS; Himanshu P. Singh, MBBS; Atul Sachan, MBBS; Soumit Dey, MBBS
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Abstract

Lymphangiomatous polyp of the nasal cavity is a very rare condition. We are reporting a case of a unilateral nasal mass presenting with noisy breathing during sleep, change of voice, watery nasal discharge, and anosmia in a 5-year-old boy. The mass was removed via a transnasal endoscopic approach, and a diagnosis of lymphangiomatous nasal polyp was established by histopathology.

Angiomatous ethmoidochoanal polyp in an infant: Case report

November 22, 2011     Nuno Oliveira, MD, Nuno Trigueiros, MD, Delfim Duarte, MD, and Manuel Rodrigues eRodrigues, MD
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Abstract

Nasal polyps are rare in children younger than 10 years. We describe the case of an infant girl who had undergone a traumatic intubation at birth that had resulted in nasal bleeding. At the age of 5 months, she was brought to us with an obstructive left nasal mass. Imaging revealed the presence of an ethmoidochoanal polyp, as well as a fracture of the posterior cribriform plate and a small associated meningocele. Four months later, the polyp was excised, and the meningocele was corrected with endoscopic nasal surgery. Pathologic evaluation identified the lesion as an angiomatous polyp, which was probably related to the previous traumatic episode. We discuss the clinical aspects of a pathologic entity that has not been previously reported in an infant.

Bilateral vocal fold polyps with occult sulcus mucosal bridge

June 13, 2011     Colleen N. Johnson, MD, MPH, MAJ USAF and Robert L. Eller, MD, MAJ USAF
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Identification of bacteria isolated from nasal polyps and their ability to produce superantigens and biofilms in Lebanese patients

March 31, 2011     Marita Chakhtoura, MS, Usamah Hadi, MD, Charbel Rameh, MD, Jihad Nassar, MD, and Alexander M. Abdelnoor, PhD
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Abstract

Staphylococcus aureus superantigens and bacterial biofilms have been implicated in the development of chronic rhinosinusitis and nasal polyps. We conducted a study of 32 Lebanese patients-21 males and 11 females, aged 15 to 71 years (mean: 39)-to identify bacteria isolated from nasal polyps and to determine if these bacteria produced superantigens and biofilms. Polyps were surgically removed, homogenized, and subjected to bacteriologic studies. The presence or absence of S aureus enterotoxin A, B, C, and D (superantigen) genes was determined in all isolates by polymerase chain reaction. Biofilm production by coagulase-negative staphylococci and Pseudomonas aeruginosa was assessed by tissue culture plate assay. A total of 34 bacterial species/groups were isolated from the nasal polyps. Of these, only 3 (8.8%) were S aureus, and only 1 possessed an enterotoxin-coding gene (enterotoxin B). Moreover, of the 21 coagulase-negative staphylococci isolates that were found, none possessed the investigated genes, and only 1 had a strong biofilm-formation property. Our results could not confirm that S aureus enterotoxins (superantigens) or biofilm-producing bacteria play a role in the development of nasal polyps in the Lebanese group studied.

Large vocal fold polyp

January 1, 2011     Venu Divi, MD, Robert T. Sataloff, MD, DMA, and Jacqueline Oxenberg, DO
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Polyps in bilateral conchae bullosa

January 1, 2011     K. Cagdas Kazikdas, MD
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Sphenochoanal polyp: Current diagnosis and management

June 30, 2010     Mohannad Ahmad Al-Qudah, MD, FICS, FAAOHNS
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Abstract

Choanal polyps arise from inflamed, edematous mucosa in the paranasal sinuses. They extend into the choana and cause nasal obstruction and mouth breathing. In most cases, these polyps arise in the maxillary sinus, but rare cases of origin in the sphenoid sinus and other nasal structures have been reported. The presence of a choanal polyp in an atypical location can lead to diagnostic confusion and exploration of the wrong sinus at surgery. The author reports the case of a 15-year-old girl who was diagnosed with a sphenochoanal polyp. The patient was successfully treated via an endoscopic surgical approach.

Influence of the macroscopic features of vocal fold polyps on the quality of voice: A retrospective review of 101 cases

March 1, 2010     Gursel Dursun, MD, Selmin Karatayli-Ozgursoy, MD, Ozan Bagis Ozgursoy, MD, Zahide Ciler Tezcaner, MD, Isil Coruh, Audiometrist, and Mehmet Akif Kilic, MD
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Abstract

We conducted a study to examine six macroscopic features of vocal fold polyps and to investigate their influence on quality of voice. We retrospectively reviewed the records of 101 consecutive patients with vocal fold polyps who had undergone microlaryngeal surgery for polyp removal after conservative measures had failed. All patients had undergone videolaryngostroboscopy and perceptual and acoustic voice analyses. The six macroscopic features of these vocal fold polyps were morphologic type, location, position, shape, size, and the presence or absence of a reactive lesion on the contralateral vocal fold. Among our statistically significant findings were that gelatinous polyps tended to be broad-based; polyps located on the superior surface tended to be hemorrhagic; small polyps were mostly located on the middle one-third of the vocal fold, and most of them were broad-based; and all of the polyps that were accompanied by reactive lesions on the contralateral vocal fold were located on the free edge. Moreover, jitter was found to be low in small polyps. Finally, noise-to-harmonics ratios were significantly higher in patients with anterior polyps and in those with pedunculated polyps. We conclude that each of the six macroscopic features of vocal fold polyps affected vocal function to a certain degree. We believe that our study provides additional information to otolaryngologists and speech language pathologists who deal with vocal fold polyps.

A giant vocal fold polyp causing dyspnea

December 1, 2009     Takeshi Kusunoki, MD, Ryohei Fujiwara, MD, Kiyotaka Murata, MD, and Katsuhisa Ikeda, MD
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Frontochoanal polyp: Case report

April 30, 2009     Alper Nabi Erkan, MD, Özcan Çakmak, MD, and Nebil Bal, MD
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Abstract

Choanal polyps are solitary benign growths that can cause unilateral nasal obstruction. A frontochoanal polyp originates from the frontal sinus and extends to the nasopharynx. These lesions are rare and are usually diagnosed by endoscopic examination and computed tomography. A 20-year-old man presented with unilateral nasal obstruction and headache. Findings on endoscopy and computed tomography suggested frontochoanal polyp, and endoscopic treatment was successful. We discuss the case and review the pertinent literature.

The floppy vocal polyp

December 1, 2008     Omar Rahmat, MD, MS and Narayanan Prepageran, FRCS
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