Fast Five Quiz: Sinusitis With Nasal Polyps

Arlen D. Meyers, MD, MBA


June 18, 2021

Figure 1. Swollen, infected sinuses with polyps, illustration.

CRS is a heterogeneous disorder with multiple inflammatory endotypes. Affected patients have bilateral benign edematous polyps extending from the paranasal sinuses to the nasal cavity; increased levels of cytokines and mediators and an intense inflammatory infiltrate are often found.

The etiology of CRSwNP may involve numerous local host factors, systemic factors, and environmental factors, which contribute to sinus inflammation and the pathophysiology of the disease. Scarring due to prior sinus surgery is one of several possible local host factors; others include sinonasal anatomical abnormalities, neoplasm, or the presence of a foreign body, among others.

Chronic sinusitis can be related to systemic factors, such as genetic diseases (eg, cystic fibrosis); conditions that cause immunodeficiency; autoimmune disease; idiopathic conditions (eg, the Samter triad [aspirin-exacerbated respiratory disease]); and acid reflux.

Evidence of type 2 airway inflammation is found in most patients with CRSwNP, and these patients have the highest disease burden. Additionally, because of the shared type 2 inflammatory pathway implicated in several coexisting diseases, patients with CRSwNP often have comorbid asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD).

Learn more about the etiology of CRSwNP.


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