EPIDEMIOLOGY OF NASAL POLYPS AT AN ARMY HOSPITAL IN PAKISTAN

Epidemiology of Nasal Polyps

Abstract

Objective: To determine the epidemiology of nasal polyps at an Army Hospital in Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted at the department of ENT, Combined Military Hospital, Peshawar over 2 years period from Jan 2000 to Dec 2002.
Patients and Methods: A total of 80 patients who were diagnosed of nasal polyps during this period were included for analysis after taking written informed consent. A predesigned proforma was used to record patient’s demographic details along with the history, physical examination, hematological and biochemical tests as well as routine radiograph of nose and paranasal sinuses.
Results: The age of the patients ranged from 15 years to 40 years with a mean of 26.13 ± 2.5 years. Majority (n=27, 33.75%) of the patients were aged between 26-30 years. There were 49 (61.25%) male and 31 (38.75%) female patients in the study group giving a male to female ratio of 1.6:1. All these patients had bilateral disease. Asthma was seen in 12 (15%) patients, drug hypersensitivity was found in 10 (12.5%) patients while 7 (8.75%)
patients had aspirin hypersensitivity. Cervical lymphadenopathy was seen in 8 (10.0%) subjects. Bilateral nasal obstruction was the most frequent presenting symptom seen in all the subjects (100%) followed by postnasal drip (92.5%), excessive sneezing (72.0%), rhino rhea (67.5%) and loss of sense of smell (63.7%). Upon clinical examination bilateral nasal polypi were confirmed in all the subjects. Nasal discharge was seen in 63 (78.75%)
patients. It was mucoids in 32 (40.0%) and purulent in 31 (38.75%) patients. Inferior turbinate hypertrophy was seen in 46 (57.5%) patients. It was bilateral in 38 (47.5%) and unilateral in 8 (10.0%) subjects; 4 (5.0%) on each side. Deflected nasal septum was seen in 49 (61.25%) patients. It was on the left in majority of the patients (36.25%). Hypertellurism was seen in 18 (22.5%) patients.
Conclusion: With a male predominance of 1.6:1 nasal polypi were seen in adults with a mean age of 29.2 ± 15.93 years. These were bilateral in all the patients and the most common presenting symptoms were nasal obstruction (100%), postnasal drip (92.5%), excessive sneezing (72.0%), rhinorrhea (67.5%) and loss of sense of smell (63.7%) in decreasing order of frequency. Asthma was seen in 12 (15%) patients, drug hypersensitivity was found in 10 (12.5%) patients while 7 (8.75%) patients had aspirin hypersensitivity. Upon clinical examination nasal discharge (78.75%), inferior turbinate hypertrophy (57.5%), deflected nasal septum (61.25%) and Hypertellurism (22.5%) were frequent findings.