Galician Medical Journal (Mar 2016)
Major Clinical Phenotypes of Polypous Rhinosinusitis
Abstract
Polypous rhinosinusitis remains one of the major problems of modern otorhinolaryngology, its prevalence in general population reaches 4%. There is a wide range of variants of clinical course and a different response to traditional methods of treatment, however all these cases are diagnosed as “polypous rhinosinusitis”. It suggests the heterogeneity of a group of patients diagnosed with “polypous rhinosinusitis” and the need for a detailed study of various clinical variants of nasal polyposis, i.e. clinical phenotypes of the disease. The objective of the research was to assess clinical features of chronic polypous rhinosinusitis depending on trigger of the disease as well as to determine clinical phenotypes of nasal polyposis. Materials and methods. The article presents the results of clinical and anamnestic investigations, radiology examinations and laboratory studies of 150 patients with various types of polypous rhinosinusitis. Patients were divided into three groups: Group I included 50 patients with aspirin-intolerant polyposis; Group II consisted of 50 patients with polyposis due to violations of aerodynamics of the nasal breathing; Group III included 50 patients with Ig-E-dependent (allergic) polyposis, Results. The research revealed significant differences in studied indicators between different clinical groups. The presence of differences in gender, age, severity of clinical symptoms and the character of pathological changes allowed us to determine the most common clinical phenotypes of polypous rhinosinusitis. Conclusions. The onset of the disease affecting primarily females in adulthood, severity of clinical manifestations, total or subtotal lesions of sinuses resulting in resistance to traditional methods of treatment are typical for patients with aspirin-intolerant polyposis. The above mentioned phenotypes are considered within a clearly defined pathology and allow us to optimize the diagnostic process as well as to determine adequate therapeutic tactics for each clinical case.
