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Sinusitis From Microbiology to Management - part 2

Từ điển y tế Stedman của, polyp một là một thuật ngữ mô tả chung với bất kỳ khối lượng của mô mà chỗ phình ra hoặc dự án ra ngoài hoặc trở lên từ các mức độ bề mặt bình thường, do đó vĩ mô có thể nhìn thấy như là một cấu trúc giống như ngọn núi hemispheroidal, dạng cầu | Classification of Rhinosinusitis 27 polyposis as a subgroup of CRS. However the lack of a good definition of nasal polyps or nasal polyposis makes utilization of this definition difficult. According to Stedman s Medical Dictionary a polyp is a general descriptive term with reference to any mass of tissue that bulges or projects outwards or upwards from the normal surface level thereby macroscopically visible as a hemispheroidal spheroidal or irregular mound-like structure growing from a relatively broad base or a slender stalk 36 . Dorland defines a polyp as a morbid excrescence or protruding growth from mucous membrane classically applied to a growth on the mucous membrane of the nose 37 . This means that any spheroidal outgrowth of the nasal mucosa in the nose or the paranasal sinuses is to be considered a nasal polyp. Some authors however consider chronic sinusitis and nasal polyposis as different diseases of the respiratory mucosa of the paranasal sinuses 38 . They define every polyp that can be seen by endoscopy as nasal polyposis and any polyp in the sinuses as hyperplasia. Ponikau stated that in the Mayo Clinic they consider nasal polyposis the end stage of the chronic inflammation process of chronic rhinosinusitis rather than two different diseases 39 . According to these authors CRS is an inflammatory disease of the nasal and paranasal sinuses that is present for more than three months and is associated with inflammatory changes ranging from polypoid mucosa thickening to gross nasal polyps. Orlandi et al. were not able to see a significant difference between the number of major and minor factors of patients with or without nasal polyps 31 . They only found that nasal dry-ness crusting not a TFR factor was more prevalent in patients with nasal polyposis. Also the Sinus and Allergy Health Partnership Taskforce SAHP described that one of the signs of inflammation must be present and identified in association with ongoing symptoms TFR guidelines Table 4 5 .