[Nasal-paranasal sinus polyposis].

UNLABELLED: 1.

POLYPOSIS AND ALLERGY: Nasosinusal polyposis and allergy must be considered as two distinct conditions. 2.

POLYPOSIS: Approximately 1% of the general population has nasosinusal polyposis, a condition strongly associated with asthma (about one-third of the patients with polyposis have asthma). Patients with nasosinusal should undergo a complete respiratory examination in order to search for asthma or an asthma equivalent. 3.

EOSINOPHILS: Eosiophils play a crucial role in the inflammatory reaction, releasing almost all the known inflammatory mediators: cytokines, chemokines and growth factors. 4.

EPITHELIAL CELL: The epithelial cell probably plays a very important role. 5.

MEDICAL TREATMENT: Long-duration intranasal corticotherapy is the basis of drug treatment. Short courses of oral corticosteroids may be useful during acute episodes in inflammation. The exact effect of oral corticosterid is not clearly elucidated but it is known that non-steroidal antiinflammatory drugs (NSAID) are contraindicated in polyposis. 6.

SURGICAL TREATMENT: Surgery is reserved for medical failures or for patients with a contraindication for drug therapy. Endonasal ethmoidectomy is the basis treatment. 7.

PERSPECTIVES: Better understanding of the underlying pathophysiology and the probable genetic component will determine future treatments. Perspectives include antiinflammatory drugs currently reserved for other conditions (antileucotriene, antiTNFa, IL-18) and elaboration of new antiinflammatory drugs.