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  1. Gendeh BS, Long YT, Misiran K
    Asian J Surg, 2004 Jan;27(1):22-5.
    PMID: 14719510
    Antrochoanal polyps are a rare clinical entity. In this review of patients treated between January 1996 and September 2002, there were 18 cases of antrochoanal polyps. The mean age of patients was 20 years. Nasal obstruction was the most common symptom (17 cases, 94%), followed by rhinorrhoea (44%), epistaxis (33%), postnasal drip (28%), and snoring (22%). Chronic sinus was the most common associated rhinological finding (50%). Various surgical approaches were used: endoscopic polypectomy and middle meatal antrostomy in seven patients (38.9%), endoscopic polypectomy and inferior meatal antrostomy in three patients (16.7%) and Caldwell-Luc surgery in one patient (5.6%). No complications were noted in patients treated with powered instrumentation, including the three patients in whom combined transcanine approaches were used. We concluded that powered endoscopic polypectomy was safe and effective. It allowed a more complete dissection and may diminish the chance of recurrence.
    Matched MeSH terms: Nasal Polyps/complications; Nasal Polyps/diagnosis; Nasal Polyps/surgery*
  2. Khoo JJ, Kumar KS
    Med J Malaysia, 2003 Jun;58(2):282-5.
    PMID: 14569751 MyJurnal
    Rhinosporidiosis is a chronic granulomatous disease of the mucous membrane, predominantly of the nose and nasopharynx. It is uncommon in Malaysia but has been seen in immigrant workers from endemic areas like India and Sri Lanka. A case seen in Johor is reported here to highlight the need of awareness among clinicians at a time where there is increasing numbers of immigrant workers in our country. The causative organism of this disease is Rhinosporidium seeberi, which is found in stagnant waters. Sporangia and endospores of R. seeberi are seen in the granulomatous polypoidal lesions. The patients commonly present with epistaxis and nasal blockage. Complete excision is the treatment of choice for this disease. Recurrences are common despite anti-microbial treatment.
    Matched MeSH terms: Nasal Polyps/diagnosis; Nasal Polyps/etiology*; Nasal Polyps/therapy
  3. Shashinder S, Kuljit S, Suhba ST, Arumainathan UD, Gopala KG
    Med J Malaysia, 2007 Mar;62(1):72-3.
    PMID: 17682578
    We describe a child who presented with intermittent respiratory obstruction especially in supine position. Examination revealed a fleshy post nasal mass extending up to the oropharynx. The mass was removed surgically and histopathology revealed an antrochonal polyp. Patient was relieved of his symptoms and has been well ever since.
    Matched MeSH terms: Nasal Polyps/complications*; Nasal Polyps/diagnosis; Nasal Polyps/pathology; Nasal Polyps/surgery
  4. Irfan M, Shamim AK
    Med J Malaysia, 2009 Mar;64(1):59-60.
    PMID: 19852324 MyJurnal
    Nasal polyp is one of the common causes of nasal obstruction. The diagnosis is usually made on clinical ground and rarely needs histological examination. However, when a candidate is selected for the surgical option of polyp removal, there is tendency to send all specimens for routine histological examination. The objective of this study was to assess the necessity of routinely performed histological examination in all nasal polyp specimens. A retrospective review of all nasal polyp histological reports was done from patients who underwent polypectomy or functional endoscopic sinus surgery in Universiti Sains Malaysia Hospital between January 2000 to July 2006. It consisted of 95 patients. Majority of the reports came back as inflammatory nasal polyp (93.6%) and other varieties of benign nasal mass (5.3%). However, one specimen was noted to be malignant (1.1%). In conclusion all nasal polyp specimens should be sent for histological examination in order to confirm the diagnosis.
    Matched MeSH terms: Nasal Polyps/pathology*
  5. Wong EHC, Chong AW
    Am J Otolaryngol, 2019 12 05;41(2):102367.
    PMID: 31831185 DOI: 10.1016/j.amjoto.2019.102367
    BACKGROUND: Many studies have looked at the effect of functional endoscopic sinus surgeries (FESS) on nasalance, nasal consonant and nasalized vowels. Only two studies investigated the effect of FESS on vocal sound quality and have not found statistically significant changes before and after operations. The aim of this study was to examine the short-term and long-term objective and subjective changes in the vocal quality of patients after FESS, comparing patients with and without nasal polyps.

    METHODS: Sixteen patients were recruited for voice analysis during pre-operative, within two weeks and at least three months post-operatively. Subjective questionnaire was used to assess perception of voice changes.

    RESULTS: There were no statistically significant changes in the acoustic parameters of patients with nasal polyposis. In patients with CRS without polyps, there was a statistically significant increase in fundamental frequency (F0) in nasal sound during early follow up. The changes in soft phonation index (SPI) values between the two groups were statistically significant during early follow-ups. Only patients with nasal polyposis perceived a subjective change in their voice post-operatively.

    CONCLUSIONS: Clinicians should inform all patients, especially voice professionals about the possible effects of endoscopic sinus surgeries on their voice quality.

    Matched MeSH terms: Nasal Polyps*
  6. M Yusoff NNF, Ahmad S, Wan Abdul Rahman WF, Mohamud R, C Boer J, Plebanski M, et al.
    Cytokine, 2024 Jun;178:156557.
    PMID: 38452440 DOI: 10.1016/j.cyto.2024.156557
    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a subtype of chronic rhinosinusitis (CRS) characterized by the presence of nasal polyps (NP) in the paranasal mucosa. Despite the complex etiology, NP is believed to result from chronic inflammation. The long-term aftermath of the type 2 response is responsible for symptoms seen in NP patients, i.e. rhinorrhea, hyposmia, and nasal obstruction. Immune cellular tolerogenic mechanisms, particularly CD4 + Foxp3 + regulatory T cells (Tregs), are crucial to curtail inflammatory responses. Current evidence suggests impaired Treg activity is the main reason underlying the compromise of self-tolerance, contributing to the onset of CRSwNP. There is compelling evidence that tumor necrosis factor 2 (TNFR2) is preferentially expressed by Tregs, and TNFR2 is able to identify the most potent suppressive subset of Tregs. Tumor necrosis factor (TNF)-TNFR2 interaction plays a decisive role in the activation and expansion of Tregs. This review summarizes current understanding of Tregs biology, focusing on the discussion of the recent advances in the study of TNF-TNFR2 axis in the upregulation of Treg function as a negative feedback mechanism in the control of chronic inflammation. The role of dysregulation of Tregs in the immunopathogenesis of CRSwNP will be analyzed. The future perspective on the harnessing Tregs-mediated self-tolerant mechanism in the management of CRSwNP will be introduced.
    Matched MeSH terms: Nasal Polyps*
  7. Sharma HS, Daud AR
    Int J Pediatr Otorhinolaryngol, 1997 Jul 18;41(1):65-70.
    PMID: 9279638
    An antrochoanal polyp, a common clinical entity, with a rare presentation is being reported. A 12 year old boy was brought to Accident and Emergency department with an unusual sudden presentation of polypoidal mass filling the oral cavity up to his incisors as a result of which he could not swallow and speak. Prior to this episode he had no complaints of the disease. An emergency removal was planned and only during the operation could it be diagnosed as a antrochoanal polyp because of its pedicle in the lateral wall of the nose, which was confirmed by histopathological examination.
    Matched MeSH terms: Nasal Polyps/pathology; Nasal Polyps/surgery*
  8. Chew YK, Noorizan Y, Khir A, Brito-Mutunayagam S, Prepageran N
    Singapore Med J, 2009 Nov;50(11):e374-5.
    PMID: 19960147
    The incidence of mucocoeles associated with a non-surgically treated nasal polyposis is rare. We report a rare case of nasal polyposis with asymptomatic frontal mucocoeles in a 28-year-old Malay man who presented with bilateral nasal obstruction with anosmia. Physical examination revealed bilateral grade III nasal polyps causing obstruction. Computed tomography revealed paranasal polyposis with a large polyp extending and expanding the posterior table of the frontal sinus causing erosion and thinning of its wall. Marsupialisation of the mucocoele and nasal polypectomy were done. Endoscopic sinus surgery and marsupialisation should be the treatment of choice for asymptomatic frontal mucocoele.
    Matched MeSH terms: Nasal Polyps/complications*; Nasal Polyps/diagnosis
  9. Nazli Zainuddin, Irfan Mohamad, Khan, Shamim Ahmed
    MyJurnal
    Fungal ball is an extramucosal mycosis. The patient may present with facial pain, nasal blockage, purulent nasal discharge and cacosmia, the fungal ball being present unnoticed for years. Some patients do present as having other nasal problems and later on are found out to have a fungal ball incidentally. We present a case of 38 yearold man who was clinically diagnosed as having left antrochoanal polyp. Intraoperatively, a fungal ball was discovered in the left maxillary antrum.
    Matched MeSH terms: Nasal Polyps
  10. Irfan Mohamad, Yahia Hussein Al-Hadeethi, Ramiza Ramza Ramli
    MyJurnal
    Introduction: This study is aimed to examine the predominant inflammatory cells in nasal polyps (NP) in the
    local community and its correlation to the clinical presentations.

    Materials and Methods: The study was
    done retrospectively looking at patients who had undergone functional endoscopic sinus surgery (FESS) in
    Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia with a histopathological diagnosis of nasal
    polyposis (NP), between the years 2004 to 2008. Sixty two patients between the ages of 18 years to 60 years
    old were selected and data relevant to the study were collected from the patient’s folders using a specially
    created form prepared for the study. The NP histopathology report from each patient underwent FESS were
    analysed and the patients were divided into eosinophilic and non eosinophilic dominant group. Clinical
    presentations from each patient were also gathered and analysed according to the NP group.

    Results: In
    HUSM, there were a higher number of eosinophilic types NP as compared to the neutrophilic type NP which
    is contrary to other study conducted on Asian populations. The clinical symptom correlations between either
    eosinophilic or non-eosinophilic type of NP have not shown any significant associations.

    Conclusion: The
    study showed that the incidence of histological subtypes of nasal polyp in HUSM is almost the same as that
    found in other parts of the world (Europe and North America) which will reduce the possibility of racial or
    geographical influence on the pathogenesis of the nasal polyp. Clinical symptoms and presentation alone are
    not enough to differentiate the type of the nasal polyp without the histological study.
    Matched MeSH terms: Nasal Polyps
  11. Tai Li Min E, Abdullah B
    Ear Nose Throat J, 2020 Nov;99(9):NP103-NP104.
    PMID: 31184208 DOI: 10.1177/0145561319856576
    Matched MeSH terms: Nasal Polyps/complications*
  12. Ho J, Hamizan AW, Alvarado R, Rimmer J, Sewell WA, Harvey RJ
    Am J Rhinol Allergy, 2018 Jul;32(4):252-257.
    PMID: 29862828 DOI: 10.1177/1945892418779451
    Background Eosinophilic chronic rhinosinusitis (eCRS) is linked with skewed T-helper 2 or immunoglobulin E (IgE)-mediated allergic responses, with differing diagnosis, prognosis, and management to non-eCRS. Objective The association between biomarkers and eCRS was investigated to assess the predictors of eCRS. Methods A cross-sectional study of adult patients with chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery was conducted. eCRS was defined by histopathological assessment showing >10 eosinophils/high-power field on sinus mucosal biopsy. Blood tests were performed preoperatively and assessed for a full blood count including eosinophils and a white cell count (WCC) as well as biochemical markers of inflammation and atopy including Immunoglobulin E (IgE), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and ImmunoCAP testing for serum-specific IgE. Comparisons between eCRS and non-eCRS patients were performed. Results 345 patients (48.1% female, age 48.72 ± 15.06 years) were recruited, with 206 (59.7%) identified as eCRS, 41% with asthma and 47% CRS with nasal polyps. eCRS patients were more likely to have asthma ( P nasal polyps ( P 0.24 × 109/L), eosinophil ratio (>4.27% of total WCC), and lower ESR when compared with non-eCRS.
    Matched MeSH terms: Nasal Polyps/complications; Nasal Polyps/diagnosis*
  13. Tikaram A, Prepageran N
    Med J Malaysia, 2013 Dec;68(6):445-7.
    PMID: 24632910 MyJurnal
    OBJECTIVE: To determine the pattern of cellular infiltration in nasal polyposis among Malaysian population and to compare the pattern of cellular infiltration in nasal polyposis between Malaysian and other Asian countries.

    MATERIAL AND METHOD: This is retrospective study done on patients diagnosed with nasal polyposis from January 2008 to June 2012 in University Malaya Medical Center. Only the patients undergoing first operation for nasal polyp and were confirmed polyp with histopathological sections were included in the study.

    RESULT: A total of 80 subjects were included in the study. Of these 48.75% had neutrophil- predominant polyp which was in contrast with the eosinophil- predominant polyp of Caucasian population but similar to other studies done in Asian countries.

    CONCLUSION: The etiology of nasal polyposis in Caucasians and Asians may be different and may need to be managed differently. It may be more appropriate to treat nasal polyposis in Asian population with long term antibiotics and more study needs to be done on this.
    Matched MeSH terms: Nasal Polyps
  14. Mohamad S, Hamid SSA, Azlina A, Md Shukri N
    Asia Pac Allergy, 2019 Jul;9(3):e22.
    PMID: 31384577 DOI: 10.5415/apallergy.2019.9.e22
    Background: Chronic rhinosinusitis (CRS) is one of the most common and complex chronic inflammatory disease of sinonasal mucosa. Even though the pathogenesis of CRS is multifactorial and still unclear, the role of cytokines especially interleukin-1 (IL-1) is being investigated worldwide in different population because of varying results obtained.

    Objective: To study the association of IL-1 (A and B) gene polymorphisms with chronic rhinosinusitis with nasal polyp (CRSwNP) and without nasal polyp (CRSsNP), and other factors related.

    Methods: This is a case-controlled study which include a total of 138 subjects recruited from Otorhinolaryngology-Head and Neck Surgery clinic in Hospital Universiti Sains Malaysia. Genotyping of the IL-1A (+4845G, +4845T) and IL-1B (-511C, -511T) were performed with restriction fragment length polymorphism analysis.

    Results: There was a statistical significant association between IL-1B (-511C, -511T) polymorphism with CRSwNP and CRSsNP (p < 0.001). The CT genotype of IL-1B was markedly increased in CRSwNP subjects (52.2%). However, there was no significant association found between IL-1A (+4845G, +4845T) with CRSwNP and CRSsNP (p = 0.093). No association was found in factors related to CRS, which included asthma, atopy, allergy, aspirin sensitivity, and family history of nasal polyp (p value of 0.382, 0.382, 0.144, >0.95, and 0.254, respectively).

    Conclusion: This study indicates an association of IL-1B (-511C, -511T) polymorphism with CRSwNP and CRSsNP in our population, hence there is a possibility of IL-1B involvement in modulating pathogenesis of CRS. There was no significant association of IL-1A (+4845G, +4845T) polymorphism with CRSwNP and CRSsNP, and other factors related.

    Matched MeSH terms: Nasal Polyps
  15. Debnath KK, Kanapaty Y, Yong DJ, Chandran S, Bakri A
    Med J Malaysia, 2019 Jun;74(3):229-230.
    PMID: 31256179
    'Pai syndrome' (PS) is a rare congenital syndrome. Presented here, a new-born baby-girl who exhibited the characteristic features of having a midline nasal (septal) polyp, an anterior alveolar process polyp, and a pericallosal lipoma associated with corpus callosum dysgenesis of the brain. Both polyps were lined with stratified-squamous epithelium. The overall features were largely consistent with those described by Pai et al., in 1987. A midline cleft-lip (with or without cleft-alveolus) is one of the most common features of the syndrome which was however absent in this case. Instead, an anterior alveolar polyp is present, which is relatively rare.
    Matched MeSH terms: Nasal Polyps
  16. Khairuddin NK, Salina H, Gendeh BS, Wan Hamizan AK, Lund VJ
    Med J Malaysia, 2018 02;73(1):1-6.
    PMID: 29531195
    OBJECTIVE: To assess the quality of life (QoL) and recurrence of disease in patients with eosinophilic (ECRSwNP) and non-eosinophilic chronic rhinosinusitis with nasal polyposis (non-ECRSwNP) post endoscopic sinus surgery (ESS).

    METHODOLOGY: A cross-sectional comparative study was carried out in the Otorhinolaryngology - HNS Department, Universiti Kebangsaan Malaysia Medical Center (UKMMC). Subjective assessments of nasal symptoms and quality of life (QoL) using SNOT-22 and Visual Analogue Scale (VAS) and objective endoscopic assessment was undertaken using a modified Hadley endoscopic examination.

    RESULTS: There was no significant statistical difference in the quality of life between the ECRSwNP and non-ECRSwNP groups as evidenced by the SNOT-22 score and the VAS comparison (p>0.05). However, there was a significant difference in terms of recurrence of disease with the presence of nasal polyps on endoscopic examination. (p = 0.016) CONCLUSION: In conclusion, we found that there is no significant difference in QoL between ECRSwNP and non- ECRSwNP. There is higher frequency of recurrence of nasal polyps amongst ECRSwNP.

    Matched MeSH terms: Nasal Polyps
  17. Sow YL, Tang IP, Kho JPY, Prepageran N
    Med J Malaysia, 2018 08;73(4):244-248.
    PMID: 30121688
    INTRODUCTION: Endoscopic sinus surgery (ESS) is the mainstay for treatment of chronic rhinosinusitis versus maximal medical therapy. We propose a more economical option, by using steroid-impregnated Gelfoam instead of Nasopore post ESS, as it is less expensive and has showed effectiveness in preventing post-operative bleeding.

    MATERIALS AND METHODS: A randomised, double-blinded, placebo-controlled trial was carried out in eight patients with chronic rhinosinusitis or nasal polyposis who were planned for bilateral endoscopic sinus surgery. A Peri-operative Sinus Endoscopy (POSE) Score and Lund-Kennedy Endoscopic Score (LKES) were recorded. The use of hydrocortisone-impregnated Gelfoam dressing versus normal saline-impregnated Gelfoam dressing were compared. Scores were repeated post-operatively at one week, three weeks and three months interval.

    RESULTS: For LKES, at the end of three months, 50% of the patients had the same score difference, 37.5% had better results on the study side while 12.5% had better results on the control side. Meanwhile, for POSE Score, at the end of three months, 75% of the patients had better score difference on the study side while 12.5% had better results on the control side.

    CONCLUSION: Gelfoam can be used as nasal packing material to deliver topical steroid after endoscopic sinus surgery. Steroid-impregnated nasal dressing after endoscopic sinus surgery may not provide better long-term outcome.

    Matched MeSH terms: Nasal Polyps/surgery*
  18. Abdullah B, Vengathajalam S, Md Daud MK, Wan Mohammad Z, Hamizan A, Husain S
    J Asthma Allergy, 2020;13:523-531.
    PMID: 33149624 DOI: 10.2147/JAA.S275536
    Purpose: The allergic phenotype of chronic rhinosinusitis (CRS) and central compartment atopic disease (CCAD) have been described. The CCAD is a radiological phenotype in patients with CRS that presents as a central mucosal disease due to allergy. The subset of patients having chronic rhinosinusitis with nasal polyps (CRSwNP) has not been well characterized. We aim to describe the clinical and radiological characterizations of patients presenting with the allergic phenotype of CRSwNP.

    Patients and Methods: A cross-sectional study at a tertiary hospital was performed. Adult patients diagnosed with CRSwNP who had both allergology and radiological assessments were enrolled. The symptoms of allergic rhinitis, Lund-Kennedy (LK) endoscopic scoring, Lund-Mackay (LM) computed tomography scan of paranasal sinuses (CTPNS) scoring, CCAD features, skin prick test (SPT) and level of specific IgE were assessed. All the patients underwent SPT for house dust mites.

    Results: A total of 38 patients were enrolled. Symptoms, endoscopic and CTPNS scores were higher in the allergy and CCAD groups compared to the nonallergy and nonCCAD groups. The symptom of "need to blow nose" was statistically significant in allergy vs nonallergy (p=0.01) and CCAD vs nonCCAD (p=0.02). There were significant differences in the endoscopic scores in both allergy and CCAD (allergy vs nonallergy, p=0.01; CCAD vs nonCCAD, p=0.03), and CT scores in both allergy and CCAD (allergy vs nonallergy, p=0.02; CCAD vs nonCCAD, p=0.02). All patients with CCAD have worse scoring than nonCCAD (LK score, p=0.03; LM score, p=0.02). Patients with allergy have more polypoidal involvement of the middle turbinates (left middle turbinate, p=0.141; right middle turbinate, p=0.074) and CCAD (left middle turbinate, p=0.017; right middle turbinate, p=0.009) than nonallergy and nonCCAD patients.

    Conclusion: Allergic phenotype of CRSwNP has a worse clinical and radiological disease burden. Optimal treatment of allergy is essential for a better outcome.

    Matched MeSH terms: Nasal Polyps
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