The Egyptian hieroglyphics records nasal polyps identified forty centuries ago. The polyps’ recurrence is also well documented, but the polyp frequency may vary from disease to disease. To select an appropriate treatment, thorough understanding of different types of the polyps is required. Although there is no standardized classification of the polyps, two common classifications based on amount of eosinophils are discussed here.
The clinical classification suggested by P. Van Cauwenberge divides nasal polyps into the following three types:
I. Unilateral polyps
The unilateral polyps are of two types: I.A. and I.B. The predominant cells in the I.A. polyps are eosinophils, whereas red blood cells (RBCs), neutrophils and lymphocytes are the principal cells in the I.B. polyps.
II. Bilateral polyps
The bilateral polyps are also further categorized considering the predominant cells. The II.A. polyps feature eosinophils while II.B. polyps contain neutrophils and lymphocytes. While treating the II.A. polyps, a doctor shall take into account allergic fungal sinusitis, allergic rhinitis, Churg-Strauss syndrome and aspirin intolerance. MRI or CT scan of the sinuses, allergy skin tests and other suitable laboratory tests are required. For instance, fungal cultures and surgical debridement may help in case of the polyp associated with allergic fungal sinusitis.
Inflammation may cause the II.B. polyps. The physician shall consider Young’s and cilia dyskinetic syndromes while treating these polyps. A chest x-ray may also require diagnosing Kartagener’s syndrome, which may accompany these polyps.
III. Miscellaneous – additional information
The third category offers more information about polyps. For example, are polyps associated with immunological abnormalities, bone erosion or anatomical reasons? Are polyps recurrent? This category can be used to analyzing other two types of polyps. For example, The “II.A1 recurrent x 3” implies bilateral polyps mainly with eosinophil cells. These polyps, reappeared thrice after the treatment, are attributed to the aspirin intolerance.
Metin Önerci classified the polyps principally into three categories: inflammatory, choanal / isolated and eosinophilic. The isolated polyps may grow from the uncinate, process, ethmoid bulla or other anatomical structures. The polyps originating from the sinus mucosa are named after the sinus involved. For example, polyps developing in the maxillary sinus are referred to as antrochoanal. The polyps in sphenoid sinus are known as sphenochoanal.
The classification also reviews additional criteria and related diseases. There are three additional criteria: allergy, asthma / COPD and acetylsalicylic acid intolerance. Granulomatosis, vasculitis, primary ciliary dykinesia, congential / acquired immune insufficiency and cystic fibrosis are associated with polyps.
We use cookies on our website to give you the most relevant experience by remembering your preferences and repeating visits. If you click on "Accept all", you agree to the use of ALL cookies. However, you can visit "Cookie Settings" to give controlled consent.
This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.
Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features.
Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.
Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc.
Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. These cookies track visitors across websites and collect information to provide customized ads.