Date on Senior Honors Thesis

5-2014

Document Type

Senior Honors Thesis

Degree Name

B.A.

Department

Anthropology

Degree Program

College of Arts and Sciences

Author's Keywords

Nasal polyposis; Polyp; Immunotherapy; Sinus; CT score; Inflammation; Allergy

Abstract

Inside the paranasal sinuses, multiple saclike masses protrude from the lining, blocking one’s sense of taste and smell, clogging one’s nose with nasal congestion, and causing a continuous runny nose with postnasal drip. This is a common case of nasal polyposis. Nasal polyposis affects up to four percent of the general population, making it one of the most common chronic diseases of the upper respiratory tract (Settipane 1996). Moreover, in cadaveric studies, the prevalence has been as high as 40% (Larson et al 1994). Nasal polyps commonly occur in adults over the age of 40, predominantly in males—with a 2:1 ratio of males to females. Young children with nasal polyps typically are diagnosed with cystic fibrosis (Mayo Clinic Staff 2011). Though polyps can be removed through Functional Endoscopic Sinus Surgery, they redevelop over time. In addition to surgical methods, physicians prescribe oral and nasal corticosteroids and antileukotrienes. Though immunotherapy treatment is not a traditional form of treatment in medical literature, there are many studies indicating that allergies may contribute to nasal polyposis. In Kentucky, where there are high counts of pollen, there may be a positive association between immunotherapy and nasal polyp recurrence. This local, retrospective study of 90 patients, with pathologically reported nasal polyps, researched any correlations between the recurrence of polyps and the use of immunotherapy treatment. It was found that immunotherapy treatment had no statistically significant effect on the number of revision surgeries or on the time to the recurrence of nasal polyps. Asthma and aspirin hypersensitivity had statistically significant correlations with higher CT scores or more severe disease. Though allergies were dominant in most of the sample population, eosinophilic presence in polyp tissue was not found to have any significant effect on the CT score (based on the Lund-Mackay staging system). Increasing the CT score indicated a shorter time to a polyp recurrence. Thus, it is recommended that patients 4 seek immediate care of polyps at lower stages of disease. More studies need to be conducted to determine any significant associations with immunotherapy treatment and nasal polyposis recurrence. Also, further studies are needed to verify the effectiveness of the recommendation for patients to treat polyps at the earliest stage to prevent further removals, chronic symptoms, and financial investments.

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