Patients with sino-nasal complaints presenting to an allergistâs or otolaryngologistâs practice frequently are diagnosed with conditions including allergic rhinitis (AR) and chronic rhinosinusitis (CRS). Furthermore, patients with CRS are pheotypically classified as CRS with and without nasal polyposis (CRWwNP and CRSsNP, repspectively). There is an intuitive sense that atopy is an underlying etiologic factor in the development of CRS, particularly CRSwNP. Certainly, many patients with CRS will have atopy. AR is observed in approximately 50% of CRS patients versus 15-20% in the population at large. However, this clinical association does not prove causality and may reflect a selection bias by which patients with symptoms of CRS, presenting to an allergistâs or otolaryngologistâs practice are more likely to undergo allergy testing. Additionally, histopathological specimens of surgically resected sino-nasal polyps often yield a diagnosis of âallergic polypâ secondary to the observation of eosinophils in the tissue. The preponderance of recent evidence, however, suggests that despite the clinical comorbidity of these conditions, AR and CRSwNP are distinct entities with overlapping presentation, rather than a continuum of disease.
(Rakesh Chandra- The Role of Atopy in Nasal Polyposis)
Last date updated on July, 2014