Nasal polyps - clinical profile and management in Ibadan, Nigeria

BACKGROUND Nasal polyps are benign mucosal protrusions into the nasal cavity of multifactorial origin and are characterized by chronic mucosal inflammation. They result from the prolapsed lining of the ethmoid sinuses and block the nose to a variable degree depending on their sizes. This study aims to evaluate the clinical profile and management of nasal polyposis as seen in Ibadan, Nigeria. METHOD A 5-year (1998-2002) prospective study of 63 nasal polyposis patients depicting the clinical profile and implications was done at the department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria. RESULTS There were 38(60%) males and 25(40%) females with M: F of 1.5:1 and with an average age of 34 years. The duration of symptoms ranged from 2months –14years with an average occurrence of 12 new cases a year. The main clinical presentations were nasal obstruction 95%, nasal discharge 81%, sneezing 59% and observed nasal polyps 78%. The polyps were found in the right nasal 16%, left nasal 25% while bilateral 37%. The rest were of antro-choanal polyps 22%. Polyps from ethmoidal region constituted 88% while from lateral nasal wall 12%. Treatment is a combination of surgery and medical therapy with topical corticosteroids. Eighty-Seven percent (87%) of the cases had surgical treatment; simple polypectomies 67%, Caldwell-Luc’s operations 15%, and external ethmoidectomies 13% while internal ethmoidectomies 5%. The hospital stay ranged from 16 weeks with recurrence rate of 13% and onset of recurrence ranged from 2 weeks – 4 years. Conclusion Whatever therapeutic regimen is used nasal polyps are a chronic common condition in which their cause remain unknown, are prone to recurrence and in some cases with embarrassing frequencies. Nasal polyps are pedunculated portions of oedematous mucosa of the nose or paranasal sinuses. Simple mucous or benign nasal polyps are an early recognizable clinical entity. They usually result from the prolapsed lining of the ethmoid sinuses and block the nose to a variable degree depending on their size . When it results from prolapsed lining of the maxillary sinus through the middle meatus backwards into the post-nasal space they are referred to as antrochoanal polyp. Polyps, which arise from the middle meatus, are pale and relatively insensitive to touch when probed; thus differentiate it from mucosa of the middle turbinate, which may be polypoid. The pale colour is due to its poor blood supply,though in the presence of repeated trauma and inflammation, they may become reddened . Nasal polyps are usually bilateral, and when unilateral may require histological evaluation to exclude the transitional cell papilloma (inverted papilloma) or malignancy. This study is designed to evaluate the clinical profile and management of nasal polyposis as seen in Ibadan, Nigeria