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  • Polip Nasi 1

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    Adli Rifki
    39 vizualizări19 pagini
    Nasal polyps are non-cancerous inflammatory growths that protrude from the nasal cavity or sinuses. They are most often caused by chronic inflammation, allergies, or asthma. The chronic inflammation causes changes that lead to increased blood vessel permeability and edema in the nasal lining, causing polyps to form. Nasal polyps are classified based on their appearance, location, associated conditions, and histological characteristics. Treatment involves medical management with steroids or surgical polypectomy depending on the size and severity of the polyps. Endoscopic sinus surgery is the preferred surgical approach.

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    Nasal polyps are non-cancerous inflammatory growths that protrude from the nasal cavity or sinuses. They are most often caused by chronic inflammation, allergies, or asthma. The chronic inflammation causes changes that lead to increased blood vessel permeability and edema in the nasal lining, causing polyps to form. Nasal polyps are classified based on their appearance, location, associated conditions, and histological characteristics. Treatment involves medical management with steroids or surgical polypectomy depending on the size and severity of the polyps. Endoscopic sinus surgery is the preferred surgical approach.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca PPT, PDF, TXT sau citiți online pe Scribd
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    39 vizualizări19 pagini

    Polip Nasi 1

    Încărcat de

    Adli Rifki
    Nasal polyps are non-cancerous inflammatory growths that protrude from the nasal cavity or sinuses. They are most often caused by chronic inflammation, allergies, or asthma. The chronic inflammation causes changes that lead to increased blood vessel permeability and edema in the nasal lining, causing polyps to form. Nasal polyps are classified based on their appearance, location, associated conditions, and histological characteristics. Treatment involves medical management with steroids or surgical polypectomy depending on the size and severity of the polyps. Endoscopic sinus surgery is the preferred surgical approach.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca PPT, PDF, TXT sau citiți online pe Scribd
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    din 19

    Dr. Sofyan, Sp.

    THT

    Definition
    Nasal polyp: inflammatory mucosal protrusion from the nasal

    and/or sinus cavities

    Aetiological factors
    - Aspirin intolerance - Cystic fibrosis - etc.

    Predisposing factors
    - Allergic reaction
    (Type I -Ig E mediated)

    Unknown causes

    Nerve damage Vasomotor denervation Gland denervation

    Mast cell degranulation Mediator release Histamine release

    Chronic inflammation of nasal mucosa Hypersensitivity of mucosal vascular bed


    Increased vascular permeability Repeated vasomotor reaction Repeated edema Accumulation of inflammatory exudate Collagen fibrils lose stability New blood vessels formation Young connective tissue formation Increased thickness of mucosal edema Polyps formation

    Classification of nasal polyp Clinical presentation Histological findings


    1. Simple polyps 2. Nasochoanal or 1. Allergic polyp

    antrochoanal polyps 3. Nasal polyps with asthma and aspirin intolerance (ASA triad) 4. Nasal polyps associated with systemic diseases 5. Allergic fungal sinusitis

    (Eosinophilic) 2. Fibroinflammatory polyp (Neutrophilic) 3. Polyp with glandular hyperplasia 4. Polyp with atypia

    Grading system for nasal polyp


    Grade I Confine in middle meatus GradeII Prolapse into nasal cavity,

    Not reaching the lower end of inf. turbinate GradeIII Reaching the floor of nasal cavity

    Characteristic of nasal polyp


    Typical nasal polyps: bilateral Polypoidal, soft, semi-translucent Whitish grey or yellow in color Smooth glistening surface Mobile, Non-painful Unresponsive to topical

    decongestants

    Endoscopy

    Differential diagnosis of nasal polyp


    Unilateral nasal mass

    1. Hypertrophic/polypoid turbinate
    2. Antrochoanal polyps 3. Mucocele 4. Benign tumors: Inverted papilloma,

    Angiofibroma 5. Malignant tumors: SCC, Adenocarcinoma

    ANTROCHOANAL POLYPS

    Frontal Mucocele

    Medical polypectomy
    1. For polyps grade I-II

    2. Prednisolone 20-40 mg/day 1-2 weeks


    3. Topical nasal steroid spray for 3 months

    4. Treatment of sinusitis
    5. Treatment of allergic rhinitis

    ENT Siriraj

    Surgical treatment
    For polyps grade III or

    failure of medical treatment 1. Snaring and inferior antrostomy 2. Intranasal ethmoidectomy 3. Caldwell-Luc operation 4. Functional Endoscopic Sinus Surgery (FESS)

    CWL

    CALDWELL-LUC OPERATION

    ENDOSCOPIC SINUS SURGERY

    ESS

    ESS :

    1.Use the endoscope for magnification and visualizatio 2. Clear the OM complex 3. Preserve the sinus mucosa as much as possible

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