A Comparative Study Of Pathology And Histology In Different Parts Of Nasal Polyps

Objective:Chronic rhinosinusitis?CRS?is a common disease in rhinology.The course of CRS is more than 3 months.The main clinical symptoms are nasal obstruction,runny nose,headache,hypoolusia,nasal distension and pain.In 2007,the European Diagnosis and Treatment Opinion for Sinusitis and Nasal Polyps?EP-OS?^[1].According to whether CRS has nasal polyps,CRS is classified as chronic rhinosinusitis with nasal polyps?c?.Chronic rhinosinusitis with nasal polys?CRSNP?and chronic rhinosinusitis without nasal polyps?CRSsNP?,in China,Li Huabin et al.^[2]According to the characteristics of sinus mucosal inflammation and whether sinus mucosal inflammation progresses to nasal polyps,it is proposed to classify CRS into eosinophilic chronic rhinosinusitis and non-eosinophilic CRS.Granulocytic CRS?non-eosinophilic chronic rhinosinusitis?,and nasal polyps can be re-typed according to the types of inflammatory cells infiltrated in the polyps.They can be divided into eosinophilic CRSNP,neutrophil CRSNP,and CRSNP with two or more kinds of cells?mostly eosinophils and neutrophils?increased.The most common type of nasal polyps is eosinophilia.Although only 25-30%of the patients with chronic rhinosinusitis have nasal polyps,the 3-year recurrence rate of nasal polyps can be as high as 75%^[4].Even with the improvement of surgical techniques this year,the recurrence rate is still high,and the probability of reoperation can reach 3%-42%^[5].Therefore,in clinical work,we find that besides the degree of disease and the difference of therapeutic effect,there are also different factors in the location of nasal polyps.The location of the lesions are mainly polyps from middle nasal meatus,polyps from uncinate process,polyps from middle turbinate,polyps from olfactory fissure,polyps from ethmoid sinus and polyps from maxillary sinus.Nasal septum-derived polyps and nasal polyps from various parts of the appeal have been extensively studied.Some studies have shown the predictive value of ethmoid sinus lesions in eosinophilic CRSNP,suggesting that the location of lesions is related to the occurrence and development of nasal polyps,but the pathological characteristics of nasal polyps in different parts have not been studied.This study intends to analyze the pathological characteristics of nasal polyps.Signs,so as to provide ideas and basis for individualized treatment of patients.Methods:From January 2018 to January 2019,patients hospitalized for Endoscopic Sinus Surgery?ESS?in our department were collected.Inclusion and exclusion criteria were formulated.Cases whose data met the inclusion criteria were collected and classified into control group:chronic rhinosinusitis group,experimental group:middle nasal meatus polyp group and posterior nasal meatus polyp group.Group A and the extensive nasal polyp group of multiple sites.Result:?1?The t-test of independent samples of inflammatory cells in 30 cases of chronic rhinosinusitis and 30 cases of middle nasal meatus polyps,4 cases of inflammatory cells,showed significant difference in the t-test values of-2.119,5.894,2.155,2.132,P<0.05,4 cases respectively;?2?The t-test of independent samples of 30 cases of chronic rhinosinusitis and 28 cases of polyps,4 kinds of inflammatory cells,respectively,was carried out with t-test values of-6.684,11.982,3.363,4.5.1,P<0.05,4 inflammatory differences were statistically significant;?3?30 cases of chronic rhinosinusitis group and 21 cases of posterior nasal polyps group,4kinds of inflammation were independently sampled by t-test.Among them,eosinophils and lymphocytes,P>0.05,there was no significant difference,while neutrophils and plasma cells,T values were-2.990,-4.614,P<0.05,respectively.??4?EOS in peripheral blood was positively correlated with EOS in pathological tissues.Conclusion:1.There is no difference in the treatment between middle turbinate polyps and widespread polyps.Surgical treatment is still the main method,and combined therapy with glucocorticoid is used after operation.There is no difference in the treatment of chronic sinusitis and posterior nasal polyps.2.Eosinophils may initiate epithelial damage and form nasal polyps,while neutrophils may inhibit eosinophils in some aspects.3.Peripheral blood EOS can be used to evaluate and judge patients with nasal polyps after surgery.