Management of nasal polyps in Calabar, South-South Nigeria

Abstract

Nasal polyps are the commonest intranasal masses. It has a worldwide distribution and significantly reduces the productivity of affected individuals. Early diagnosis and treatment can lead to better treatment outcomes. The aim of the study were: To study the occurrence, types, associated co-morbidities, and management of polyps in Calabar, Nigeria. A retrospective study of all nasal polyps seen between January 2009 and January 2019. Records of all intranasal masses seen during the period including age, sex, aetiopathological profile, and histopathology results were obtained from the records department, theater, and the wards. Patients who had nasal polyps either had nasal polypectomy with/without antral lavage, or Caldwell Luc operation. One hundred and eighty-two intranasal masses were seen during the study period. One hundred and thirty-four of them (73.625%) were nasal polyps; 62.6% were inflammatory polyps, 14.7% had chronic rhinitis, 9.7% inverted papilloma, and 2.24% squamous cell carcinoma. About 31.3% of the polyps were right-sided, 31.3% bilateral, 26.9% left-sided, and 10.44% antrochoanal polyps. About 97% of the patients presented with nasal blockage, 53.23% with rhinorrhoea, 41.79% signs of anosmia, and 29.85% sneezing. Comorbidities seen include diabetes mellitus 1.6%, hypertension 4.5%, allergy 70%, and asthma 25%.Squamous cell carcinoma was the most common malignancy found and inverted papilloma was the most common benign tumor present. Nasal polyps occur globally. They are the most common intranasal masses. They seem to occur more in males and occurrence increases with age. Not all nasal polyps turn out as polyps histologically as this study shows; we had chronic rhinitis, inverted papillomas, squamous cell carcinomas, etc. The comorbidities found were diabetes mellitus, hypertension, allergy, and asthma. Diabetes and hypertension may have been incidental but the number of patients with asthma and allergy shows a definite link between these two and allergy. Treatment for nasal polyps may be medical or surgical and the best form of surgery is endoscopic sinus surgery. However, financial constraints could prevent patients access to FESS.