Chronic Rhinosinusitis with nasal polyps  만성 충농증과 비 폴립(비용)

The incidence of idiopathic nasal polyps increases with age to a peak in the sixth decade. Nasal polyps are very uncommon before the third decade of life; a diagnosis of polyps in childhood should prompt investigation for cystic fibrosis. Nasal polyps usually occur in both nasal passages, although they may be asymmetric in size; polyps that occur in only one nasal passage should arouse suspicion for benign or malignant tumors, particularly in the presence of bloodstained nasal discharge.

  What clinical features raise suspicion for a diagnosis other than idiopathic nasal polyps?

The incidence of idiopathic nasal polyps increases with age to a peak in the sixth decade. Nasal polyps are very uncommon before the third decade of life; a diagnosis of polyps in childhood should prompt investigation for cystic fibrosis. Nasal polyps usually occur in both nasal passages, although they may be asymmetric in size; polyps that occur in only one nasal passage should arouse suspicion for benign or malignant tumors, particularly in the presence of bloodstained nasal discharge.

  Is biopsy necessary to confirm a diagnosis of nasal polyps?

Endoscopy is usually necessary to confirm the diagnosis of nasal polyps, although anterior rhinoscopy may allow large polyps to be visualized. Biopsy is rarely required for diagnostic purposes unless the polyps are observed on only one side. However, histopathological examination may provide useful prognostic information; tissue eosinophilia (>10 cells per high-power field) has been associated with higher rates of recurrence.

NEJM 7/3/2019