Olfactory Disorder is The Specific Symptom to Distinguish Eosinophilic From Non-Eosinophilic Nasal Polyps

Abstract Background: Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) have poorer outcomes after endoscopic sinus surgery and a higher recurrence rate. This study aimed to investigate the profile of clinical symptoms of eCRSwNP and the related risk factors.Methods: We prospectively enrolled 298 CRSwNP inpatients from February 2019 to December 2019. Patients were divided into eCRSwNP and non-eCRSwNP groups based on the percentage of blood eosinophils. Clinical data on questionnaires, visual analogue scale (VAS) scores, and laboratory tests were collected. The differences in clinical symptoms, including nasal congestion, rhinorrhea, olfactory disorders, and head/facial pain, between the two groups were analyzed to identify the influential factors. Logistic analysis and receiver operating characteristic curves were used to determine the diagnostic benefit for the specific symptom in eCRSwNP patients.Results: Of the four major clinical symptoms, nasal congestion and olfactory disorders were significantly different between eCRSwNP and non-eCRSwNP groups. Patients with eCRSwNP more frequently complained about olfactory disorders (P = 0.002), while patients with non-eCRSwNP mostly had nasal congestion (P = 0.001). The logistic analysis showed that the primary risk factors for olfactory disorders of eCRSwNP were disease duration (P = 0.014) and alcohol intake (P = 0.012). Olfactory disorders were not associated with the disease course of eCRSwNP but were correlated with the disease duration of non-eCRSwNP (P = 0.008). When the clinical duration was less than 10 years, there was a significant difference in olfactory disorders between eCRSwNP and non-eCRSwNP groups (P < 0.01). However, when the clinical duration was over 10 years, the difference was not statistically significant (P = 0.264). The VAS score of olfactory disorders of over 5.75 could be used to predict the diagnosis of eCRSwNP (area under the curve ＝0.674, 95% confidence intervals: 0.559–0.689, P = 0.000). Conclusions: Olfactory disorder was the major nasal symptom that could be used to distinguish eCRSwNP and non-eCRSwNP. ECRSwNP patients were more prone to have olfactory dysfunction. Our findings suggest that evaluation of nasal symptoms will help diagnose eCRSwNP and determine subsequent clinical treatment strategies.

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Olfactory Disorder is the Specific Symptom to Distinguish Eosinophilic from non-eosinophilic Nasal Polyps

10.21203/rs.3.rs-60539/v1 ◽

2020 ◽

Author(s):

Xiaodan Pan ◽

Yuan Zhang ◽

Chengshuo Wang ◽

Luo Zhang

Keyword(s):

Risk Factors ◽

Nasal Polyps ◽

Disease Duration ◽

Clinical Symptoms ◽

Nasal Congestion ◽

Sinus Surgery ◽

Specific Symptom ◽

Logistic Analysis ◽

Significant Difference ◽

Olfactory Disorder

Abstract Background: Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) have poorer outcomes after endoscopic sinus surgery and a higher recurrence rate. This study aimed to investigate the profile of clinical symptoms of eCRSwNP and the related risk factors.Methods: We prospectively enrolled 298 CRSwNP inpatients from February 2019 to December 2019. Patients were divided into eCRSwNP and non-eCRSwNP groups based on the percentage of blood eosinophils. Clinical data on questionnaires, visual analogue scale (VAS) scores, and laboratory tests were collected. The differences in clinical symptoms, including nasal congestion, rhinorrhea, olfactory disorders, and head/facial pain, between the two groups were analyzed to identify the influential factors. Logistic analysis and receiver operating characteristic curves were used to determine the diagnostic benefit for the specific symptom in eCRSwNP patients.Results: Of the four major clinical symptoms, nasal congestion and olfactory disorders were significantly different between eCRSwNP and non-eCRSwNP groups. Patients with eCRSwNP more frequently complained about olfactory disorders (P = 0.002), while patients with non-eCRSwNP mostly had nasal congestion (P = 0.001). The logistic analysis showed that the primary risk factors for olfactory disorders of eCRSwNP were disease duration (P = 0.014) and alcohol intake (P = 0.012). Olfactory disorders were not associated with the disease course of eCRSwNP but were correlated with the disease duration of non-eCRSwNP (P = 0.008). When the clinical duration was less than 10 years, there was a significant difference in olfactory disorders between eCRSwNP and non-eCRSwNP groups (P < 0.01). However, when the clinical duration was over 10 years, the difference was not statistically significant (P = 0.264). The VAS score of olfactory disorders of over 5.75 could be used to predict the diagnosis of eCRSwNP (area under the curve ＝0.674, 95% confidence intervals: 0.559–0.689, P = 0.000). Conclusions: Olfactory disorder was the major nasal symptom that could be used to distinguish eCRSwNP and non-eCRSwNP. ECRSwNP patients were more prone to have olfactory dysfunction. Our findings suggested that evaluation of nasal symptoms would help diagnose eCRSwNP and determine subsequent clinical treatment strategies.

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Evaluation of nasal symptoms to distinguish eosinophilic from noneosinophilic nasal polyps based on peripheral blood

Allergy and Asthma Proceedings ◽

10.2500/aap.2021.42.210004 ◽

2021 ◽

Vol 42 (3) ◽

pp. 214-221 ◽

Cited By ~ 1

Author(s):

Xiaodan Pan ◽

Yuan Zhang ◽

Chengshuo Wang ◽

Luo Zhang

Keyword(s):

Risk Factors ◽

Nasal Polyps ◽

Disease Duration ◽

Clinical Symptoms ◽

Nasal Congestion ◽

Influential Factors ◽

Sinus Surgery ◽

Limiting Factor ◽

Specific Symptom ◽

Logistic Analysis

Background: Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) have poorer outcomes after endoscopic sinus surgery and a higher recurrence rate. Objective: This study aimed to investigate the profile of clinical symptoms of eCRSwNP and the related risk factors. Methods: We prospectively enrolled 298 inpatients with CRSwNP from February 2019 to December 2019. The patients were divided into eCRSwNP and non-eCRSwNP groups based on the percentage of blood eosinophils; the cutoff value was set at 3.05%. Clinical data on questionnaires, visual analog scale (VAS) scores, and laboratory tests were collected. The differences in clinical symptoms, including nasal congestion, rhinorrhea, olfactory disorders, and head and/or facial pain, between the two groups were analyzed to identify the influential factors. Logistic analysis and receiver operating characteristic curves were used to determine the diagnostic benefit for the specific symptom in the patients in the eCRSwNP group. Results: Nasal congestion and olfactory disorders were significantly different between the eCRSwNP and non-eCRSwNP groups. The patients in the eCRSwNP group more frequently had concerns about olfactory disorders (p = 0.002), whereas patients in the non-eCRSwNP group mostly had nasal congestion (p = 0.001). The logistic analysis showed that the primary risk factors for olfactory disorders of eCRSwNP were disease duration (p = 0.014) and alcohol intake (p = 0.012). Olfactory disorders were not associated with the disease course of the eCRSwNP group but were correlated with the disease duration of non-eCRSwNP (p = 0.008). A VAS score for the olfactory disorders of >5.75 could be used to predict the diagnosis of eCRSwNP (area under the curve, 0.674 [95% confidence intervals, 0.559‐0.689]; P < 0.001). Conclusion: Olfactory disorder might be the major nasal symptom that could be used to distinguish a peripheral eosinophilia‐based definition of eCRSwNP and non-eCRSwNP. The disease duration was a limiting factor for using olfactory to distinguish two subgroups of nasal polyp. The investigation with regard to the accurate time boundary should be further addressed.

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Effects of Age on Recovery of Olfactory Function After Endoscopic Sinus Surgery and Related Risk Factors

Ear Nose & Throat Journal ◽

10.1177/01455613211012927 ◽

2021 ◽

pp. 014556132110129

Author(s):

Weiping Qi ◽

Liang Feng ◽

Fengyan Yang ◽

Weihuan Ma

Keyword(s):

Risk Factors ◽

Allergic Rhinitis ◽

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Protective Factor ◽

Olfactory Function ◽

Sinus Surgery ◽

The Poor ◽

Related Risk ◽

Good Improvement

Objectives: To study the effects of age on the olfactory function recovery of chronic rhinosinusitis patients after endoscopic sinus surgery and related risk factors. Methods: A total of 176 chronic rhinosinusitis (CRS) patients enrolled from February 2017 to October 2019 were divided into child, youth, middle-aged, and elderly groups. Their baseline data, T&T olfactory test score, visual analogue scale (VAS) olfactory score, sinus computed tomography (CT) Lund-Mackay score, and Lund-Kennedy score were compared. Based on postoperative olfactory function, they were divided into good and poor improvement groups. Results: Complication with nasal polyps, allergic rhinitis history, and sinus surgery history had significant differences among patients of different ages ( P < .05). Three months after surgery, T&T olfactory, VAS olfactory, Lund-Mackay, and Lund-Kennedy scores all rose with increasing age, with significant differences between any 2 groups ( P < .05). The improvement of postoperative olfactory function became poorer with aging ( P < .05). T&T and VAS olfactory scores had significant positive correlations with Lund-Mackay and Lund-Kennedy scores ( P < .001). Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications were risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment was a protective factor for good improvement. Conclusions: The improvement of olfactory function of CRS patients after endoscopic sinus surgery declines with aging. Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications are risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment is a protective factor for good improvement.

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A comparative study of microdebrider assisted versus conventional endoscopic sinus surgery for nasal polyposis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192725 ◽

2019 ◽

Vol 5 (4) ◽

pp. 1030

Author(s):

Ranganath Kumar Datta ◽

Ramya Bandadka ◽

Lakshmi Priya Shelly

Keyword(s):

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Nasal Polyposis ◽

Operative Time ◽

Sinus Surgery ◽

Nasal Discharge ◽

Recurrence Rates ◽

Conventional Instruments ◽

Number Of Patients ◽

Significant Difference

Background: Nasal polyps are benign, chronic, inflammatory lesions arising from the mucosa of the nasal sinuses or from the mucosa of the nasal cavity. They are a challenge to treat due to their uncertain etiology and tendency to recur. Therapy involves both medical and surgical treatment. Surgical management includes Endoscopic sinus surgery using conventional instruments or by microdebrider.Methods: We conducted a study on 80 patients with nasal polyposis in whom conservative management failed. They were equally randomised into powered and conventional instruments Endoscopic Sinus Surgery (ESS) groups. The groups were compared for surgical outcomes, intra and postoperative complications and recurrence rates. Results: Age of patients suffering from bilateral nasal polyposis ranged from 18 to 55 years with maximum number of patients in the group 31 to 40 years. Nasal polyps were more commonly seen in men (53.75%) than women (46.25%). Most common symptom experienced was nasal obstruction (100%), followed by olfactory disturbance in 88.7% and nasal discharge in 76.25%. There was statistically significant difference in operative time, blood loss and postoperative synechiae, with the microdebrider group showing better outcomes. There was no statistically significant difference in the postoperative VAS (visual analogue score) and recurrence rates between the two groups.Conclusions: Powered endoscopic sinus surgery offers a better therapeutic approach for patients with nasal polyposis than with conventional instruments. It provides bloodless operative field with better visualisation for a more precise, less traumatic procedure with shorter operative time.

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Efficacy and safety of paclitaxel drug-eluting balloons in femoropopliteal artery disease: a prospective observational study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213931 ◽

2021 ◽

Vol 9 (10) ◽

pp. 3051

Author(s):

Mohammed Hidayathulla ◽

Nagesh .

Keyword(s):

Risk Factors ◽

Clinical Symptoms ◽

Efficacy And Safety ◽

Femoropopliteal Artery ◽

Peripheral Angioplasty ◽

Significant Difference ◽

Drug Eluting ◽

Unhealthy Diet ◽

Artery Disease ◽

Drug Eluting Balloon

Background: The femoropopliteal artery is most frequently involved artery in peripheral artery disease. To treat femoropopliteal artery disease (FPAD), various revascularization approaches have been available such as simple balloon angioplasty, debulking techniques, stent implantation, and recently the drug-eluting balloon (DEBs). Nowadays, the paclitaxel DEBs have been emerged to treat FPAD with promising outcomes. We therefore evaluate the efficacy and safety of paclitaxel DEBs in patients with lower limb FPAD.Methods: In total, 25 patients with FPAD were enrolled in the study. All patients underwent peripheral angioplasty using paclitaxel DEBs via antegrade femoral approach or contralateral femoral artery using crossover sheath. Demographics, risk factors, clinical characteristics, and pre- and post-procedure VascuQol-6 score were noted.Results: Out of 25 patients, the majority of patients (52%) were in the 6th decades of life. The incidence of FPAD was most common in patients with an O +ve blood group. The common risk factors of FPAD, include smoking (88%), diabetes (68%), dyslipidemia (68%), and hypertension (64%). Rest pain (64%) and ulcer (32%) were the most frequent clinical symptoms of FPAD. The percent stenosis was 100% in 17 patients, and 70-99% in 32 patients. A statistically significant difference was found in VascuQol-6 score between pre and post peripheral angioplasty (p<0.001).Conclusions: We have concluded that the paclitaxel DEBs are safe and efficacious in treating FPAD. Authors recommend that clinician should educate FPAD patients pertaining to modification of controllable risk factors such as cessation of smoking, unhealthy diet, sedentary lifestyle, high blood pressure, and high blood sugar.

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Study to Determine the Incidence of Allergic Fungal Sinusitis among Patients with Nasal Polyps and Its Related Risk Factors

10.53350/pjmhs211571860 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1860-1863

Author(s):

Bakht Zada ◽

Ejaz Ahmed ◽

Muhammad Habib ◽

Zafar Iqbal ◽

Rehan Saleem ◽

...

Keyword(s):

Risk Factors ◽

Nasal Septum ◽

Nasal Polyps ◽

Bone Erosion ◽

Histopathological Examination ◽

Sinus Surgery ◽

Fungal Sinusitis ◽

Deviated Nasal Septum ◽

Allergic Fungal Sinusitis ◽

Turbinate Hypertrophy

Aim: To govern the incidence of allergic fungal sinusitis in patients with nasal polyposis. Various anatomical risk factors were also investigated, including turbinate hypertrophy, deviated nasal septum and comorbidities such as asthma and diabetes. Study Design: This is a Descriptive cross-sectional study. Place and duration of study:The study was conducted at ENT Head &Neck Surgery department, Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for the duration of six months from May 2020 to October 2020. Methods: 110 patients with nasal polyps were evaluated and operated on. Samples were sent for histopathological examination and culture. All patients were assessed with clinical examination and detailed history. Laboratory tests were performed including complete blood counts, urea, electrolytes, ECG and chest radiographs for the suitability of general anesthesia as a prerequisite for surgery. In 95% of cases, computed tomography was recommended to check for sinus involvement, bone erosion, osteo-hypertrophic complex, turbinate hypertrophy, nasal septal deviation, and intracranial and intra-orbital enlargement. MRI examinations were also recommended in cases of suspected intraocular and intracranial disease (5%). Data was scrutinized on a computer using SPSS version 22.0. Results:Of the 110 patients, 65 were male and 45 were female, with a mean age of 1and ranged from 7 to 80 years. All patients had nasal polyps. The incidence of AFS was approximately 29.1% and the remaining 78 had a different pathology. Major deviation of the nasal septum and bilateral hypertrophy of the inferior turbinate’s were observed in 6 (18.7%) and 4 (12.5%) patients, respectively. Unilateral nasal polyps were observed in 7 (21.9%) patients and bilateral nasal polyps in 18 (52.3%). 19/32 (59.4%) of the cases underwent functional endoscopic surgery of the paranasal sinuses, and in 6 (18.7%) external fronto-ethmoidectomy. Two patients underwent nasal ethmoidectomy. Septoplasty and endoscopic sinus surgery were performed in a total of 3 (9.37%) cases. Key words:Allergic bronchopulmonary aspergillosis (ABPA), Allergic fungal sinusitis (AFS).

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Expression of Interleukin-5, Interleukin-8, and Interleukin-10 mRNA in the Osteomeatal Complex in Nasal Polyposis

American Journal of Rhinology ◽

10.1177/194589240501900202 ◽

2005 ◽

Vol 19 (2) ◽

pp. 117-123 ◽

Cited By ~ 17

Author(s):

Yue-Shih Chen ◽

Sonja F. Arab ◽

Martin Westhofen ◽

Johann Lorenzen

Keyword(s):

Messenger Rna ◽

Nasal Polyps ◽

Chronic Sinusitis ◽

Clinical Symptoms ◽

Middle Turbinate ◽

Interleukin 10 ◽

Lateral Part ◽

Tissue Samples ◽

Osteomeatal Complex ◽

Significant Difference

Background Several cytokines are expressed in chronic sinusitis with and without underlying allergy. Their local production and regulation in the osteomeatal complex, the key area of paranasal sinuses, still is not fully understood. This study was performed to investigate differences of cytokine messenger RNA (mRNA) expression between the medial and the lateral part of the middle turbinate and anterior ethmoid mucosa of allergic and nonallergic patients. Methods Using the LightCycler system for real-time reverse-transcription polymerase chain reaction, we investigated the content of interleukin (IL)-5, IL-8, and IL-10 mRNA in tissue samples from middle turbinates and anterior ethmoids of 18 patients with chronic sinusitis and nasal polyps. Inferior turbinate mucosa of six control subjects without sinusitis and allergy served as control. Results IL-5 mRNA was detectable in 32 (60%) of 54 samples (two of six controls) in significant different amounts between the various locations (p ≤ 0.001). Anterior ethmoid mucosa (0.96 ± 0.99) expressed the highest amount of IL-5 mRNA followed by the lateral (0.37 ± 0.54) and the medial portion of the middle turbinate (0.12 ± 0.29) with no difference between allergic and nonallergic subgroups. IL-8 was detected in significant higher amounts in all three origins with no significant difference in concentrations between the examined locations as compared with controls. Patients expressed either IL-5 or IL-8 or both cytokine mRNA. IL-10 was expressed in all three specimens from five of eight allergic patients. All five individuals with clinical symptoms of allergy at the time of operation expressed IL-10 in at least one specimen. Conclusions IL-5 cytokine expression in the osteomeatal complex is linked to the presence of nasal polyps, whereas IL-8 is up-regulated without distinct correlation to nasal polyps. IL-10 expression was detectable in five of eight allergic patients.

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Efficacy of Dexamethasone Versus Fluticasone Nasal Sprays in Postoperative Patients With Chronic Rhinosinusitis With Nasal Polyps

American Journal of Rhinology and Allergy ◽

10.1177/1945892419841355 ◽

2019 ◽

Vol 33 (5) ◽

pp. 478-482 ◽

Cited By ~ 1

Author(s):

Kristin A. Seiberling ◽

Stephanie C. Kidd ◽

Grace H. Kim ◽

Christopher A. Church

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Standard Dose ◽

Controlled Trial ◽

Sinus Surgery ◽

Double Blind ◽

Nasal Sprays ◽

Significant Difference ◽

Nasal Steroid ◽

Snot 22

Background Topical nasal steroids are commonly prescribed to patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) following endoscopic sinus surgery (ESS). They are found to be effective in improving symptoms and quality of life as well as reducing the incidence of nasal polyps recurrence. Objective We sought to determine whether a higher concentration of topical nasal steroid spray is more effective than the standard nasal steroid spray in controlling symptoms and preventing recurrence of polyps in patients with CRSwNP who underwent ESS. Method A double-blind randomized controlled trial was performed on patients with CRSwNP after ESS. Patients were randomized into 2 treatment groups: one received topical nasal dexamethasone 0.032% and the other, fluticasone proprionate. The 22-item Sino-Nasal Outcome Test (SNOT-22) and Lund-Kennedy nasal endoscopy scores were measured at the initiation of topical nasal steroid treatment and then at approximately 4-, 8-, and 12-week intervals. Results Thirty-nine patients were enrolled in the study. Eighteen patients continued using the medications prescribed to them for the duration of the study. There were 8 patients in the dexamethasone group and 10 patients in the fluticasone group. Both groups saw significant improvements in postoperative SNOT-22 and Lund-Kenney scores over time. There was no significant difference in improvement between the groups. Conclusion There is no significant increased benefit in using a higher dose nasal steroid spray compared to the standard dose nasal steroid spray after ESS.

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Prevalence of Eosinophilic/Non Eosinophillic Nasal Polyps and Analysis of Their Presentation in Hospital Universiti Sains Malaysia Kelantan, Malaysia

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i2.332 ◽

2020 ◽

Vol 16 (2) ◽

Author(s):

Ramiza Ramza Ramli ◽

Irfan Mohamad ◽

Yahia Hussein Al-Hadeethi

Keyword(s):

Nasal Polyp ◽

Nasal Polyps ◽

Local Community ◽

Clinical Symptoms ◽

Histological Study ◽

Inflammatory Cells ◽

Sinus Surgery ◽

Histopathological Diagnosis ◽

Dominant Group ◽

Clinical Presentations

Introduction: This study is aimed to examine the predominant inflammatory cells in nasal polyps (NP) in the local community and its correlation to the clinical presentations. Materials and Methods: The study was done retrospectively looking at patients who had undergone functional endoscopic sinus surgery (FESS) in Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia with a histopathological diagnosis of nasal polyposis (NP), between the years 2004 to 2008. Sixty-two patients between the ages of 18 years to 60 years old were selected and data relevant to the study were collected from the patient’s folders using a specially created form prepared for the study. The NP histopathology report from each patient underwent FESS were analysed and the patients were divided into eosinophilic and non-eosinophilic dominant group. Clinical presentations from each patient were also gathered and analysed according to the NP group. Results: In HUSM, there were a higher number of eosinophilic types NP as compared to the neutrophilic type NP which is contrary to other study conducted on Asian populations. The clinical symptom correlations between either eosinophilic or non-eosinophilic type of NP have not shown any significant associations. Conclusion: The study showed that the incidence of histological subtypes of nasal polyp in HUSM is almost the same as that found in other parts of the world (Europe and North America) which will reduce the possibility of racial or geographical influence on the pathogenesis of the nasal polyp. Clinical symptoms and presentation alone are not enough to differentiate the type of the nasal polyp without the histological study.

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Epidemiology of nasal polyps in hilly areas and its risk factors

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20164788 ◽

2016 ◽

Vol 3 (1) ◽

pp. 77

Author(s):

Manpreet Singh Nanda ◽

Shenny Bhatia ◽

Vipan Gupta

Keyword(s):

Risk Factors ◽

Nasal Polyps ◽

Clinical Symptoms ◽

High Rate ◽

Unknown Etiology ◽

Nasal Discharge ◽

Hilly Region ◽

Polyp Recurrence ◽

Prevention And Cure ◽

Allergy And Asthma

Background: Nasal polyps are common nasal disorders with unknown etiology and high recurrence and high prevalence of 1-4% which affect the quality of patient life. The aim of the study was to find out the prevalence of nasal polyps in our hilly region and find out its etiological or risk factors for better prevention and cure of the disease.Methods: 60 patients with nasal polyps were included in this study and were assessed for age and sex distribution, types of polyps, main clinical symptoms and their duration, their major etiological or risk factors through detailed history taking, physical and nasal examination, anterior and posterior rhinoscopy, diagnostic nasal endoscopy and computerized tomography scan. Results: Nasal polyps are more common in males and in middle age group. Most of the common types are bilateral and ethmoidal polyps. Most of the patients were symptomatic with nasal obstruction and nasal discharge as main symptoms. There was strong correlation between nasal polyps and recurrent nasal infection, allergy and asthma. In this region we found familial inheritance of this disease and high rate of polyp recurrence after medical or surgical therapy.Conclusions: Nasal polyps are common in hilly region with high rate of recurrence with nasal infection, allergy and asthma being the important etiological factors.

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