Nasal Polyps : The Relationship to Allergy, Sinonasal Infection and Histopathological Type
VIRAT KIRTSREESAKUL, MD*
Affiliation : * Division of Allergy and Rhinology, Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Objective : To evaluate the relationship of nasal polyps to allergy, sinonasal infection and histopathological type by examining the prevalences of these factors among nasal polyps patients. Study
Design : Prospective descriptive study.
Materials and Methods : A total of 73 patients were enrolled between October 1" , 1999 and August 31", 2002 at the Allergy and Rhinology Clinic, Faculty of Medicine, Songklanagarind Hospital. The medical history was recorded. Allergy skin prick test, nasal endoscopy with biopsy and plain film paranasal sinus were performed. Positive allergy skin test was defined by at least 1 aeroallergen with a wheal size ~ 3 mm greater than the negative control. Rhinosinusitis was diagnosed by clinical symp toms, positive nasal endoscopy and/or positive plain film paranasal sinus. Histopathological investiga tion was classified as eosinophil-or neutrophil-dominated inflammation.
Results : 68.5 per cent of patients with nasal polyps had a positive allergy skin test, 67.1 per cent had rhinosinusitis. Eosinophil-dominated inflammation was presented in 69.9 per cent and neutro phil-dominated inflammation in 30.1 per cent, respectively. Within each histopathological type, 62.7 per cent of patients with eosinophil-dominated inflammation and 81.8 per cent of patients with neutro phil-dominated inflammation had a positive allergy skin test. There was no statistically significant difference in prevalence of positive allergy skin test between eosinophil- and neutrophil-dominated = inflammations (p 0.1 07). 60.8 per cent of patients with eosinophil-dominated inflammation and 81.8 per cent of patients with neutrophil-dominated inflammation had rhinosinusitis. There was no statisti cally significant difference in prevalence of rhinosinusitis between eosinophil- and neutrophil-domi = nated inflammations (p 0.079).
Conclusion : Nasal polyps had association with positive allergy skin test (68.5%), rhino sinusitis (67.1 %) and eosinophil-dominated inflammation (69.9%). There were no statistically signifi cant differences in prevalence of positive allergy skin test and rhinosinusitis between eosinophil-and neutrophil-dominated inflammations (p = 0.107 and p = 0.079, respectively).
Keywords : Allergy, Sinonasal Infection, Histopathology and Nasal Polyps
