Nasal polyps | Respiratory system diseases | NCLEX-RN | Khan Academy
25
August

By Adem Lewis / in , , , , , , /


– [Voiceover] What are nasal polyps? The short answer is that a nasal polyp is an overgrowth of
tissue inside your nose. But to better understand
exactly what is going on, we should talk about what’s
supposed to be inside your nose. Normally, the inside of
your nose is lined by this pink, squishy tissue
known as nasal mucosa. This tends to be a
paper-thin layer of cells that lines the majority of
the inside of your nose, although there are some areas that can be quite a bit thicker. In fact, over the course of a day, some areas of nasal mucosa
will swell and de-swell, and sometimes you can
actually feel that happening. But what happens if something goes wrong? Let’s say, for instance,
that this particular nose has allergies to pollen. And here I’m drawing in a
couple of pollen grains, quite a bit larger than they actually are, as they’re getting
inhaled up into the nose. In people with allergic rhinitis, this sets off a chain reaction of inflammation inside the nose, and one particular thing that can happen, in the setting of chronic
allergic rhinitis, is that that nasal mucosa
becomes so irritated that it starts to grow and expand. And, in fact, chronic allergic rhinitis is the number one cause of nasal polyps. So, let’s say after a long
time of being inflamed, this particular patch
right here decides to become a little bit bigger
and a little bit thicker. First it may form a little bump, but over time that bump can become bigger, and it can become bigger
and bigger and bigger, until it’s quite large. Now, it may seem that this is acting a little bit like a tumor,
and it is a sort of neoplasm, but this isn’t a malignant process. It tends to just hang out in the nose, but that’s not exactly a good thing. The nose is a sensitive area. There’s a lot of things
that need to happen. There’s lots of things that
you may not even realize drain into your nose. For instance, your sinuses all
live right next to your nose, and if a large polyp, like this one, decides to get in the way of
the outlet of those sinuses, that can cause further problems
with chronic sinusitis. So, a couple more facts about nasal polyps before we go on to some
real-world examples. These are actually fairly
common things to happen, at least in adults. It’s one of the more common
intranasal growths that occur, however, if you see it in kids,
that’s much more uncommon. In fact, in kids it’s
mostly seen only in patients which have cystic fibrosis. Another fun fact to
know about nasal polyps. There’s an association with
other types of allergic disease, but in particular there’s an association with the combination of asthma and a specific allergy to aspirin. Some people will call
the combination of asthma and allergy to aspirin and
nasal polyps an allergic triad. So, let’s go ahead and look
at those real-world examples. Now, the first thing to go over is a little bit of normal anatomy. Here, I’ve got pulled up a
single patient’s CAT scan, but I’d like to point out a few things before we go on to a patient
who has nasal polyps. The image on the left is a coronal image, and what that means is
basically it looks like you’re looking at the
patient’s face straight on, and you can kind of see that. So, I’ll point out a few structures here. First, we can see the
eyes, one on each side. We have the tongue down here in the mouth. You can see a few teeth
adjacent to the tongue. But we’re going to be
focused in particular on this area in here, and this is the patient’s
nasal cavity and sinuses. So, these larger spaces that
are filled in with black, that black is air. These are the maxillary sinuses. This straight thing running down the center of the patient’s
nose is the septum, and then we have these
little curly-cue things that hang off the wall
of the maxillary sinus, and these are called turbinates. Up here at the top of the nasal cavity, these air-filled spaces
are the ethmoid sinuses, also called the ethmoid air cells. All of these structures inside the nose are actually lined by that mucosa that we were talking about earlier. So, I’ll draw in here. You can actually not really even see it when it’s as thin as it’s supposed to be, but it gets thicker around the turbinates, and you can see some of that
here, and all of this pink that I’m drawing in here, that’s mucosa. Now, this image over
here is an axial image, and this axial image is
basically what we would get if we took a slice that
ran about right here through this patient’s head
and looked at only that slice. You can see some of the same structures. Here we have a turbinate. Here we have the nasal septum. Here we have a maxillary sinus, and up at the front here,
we have the patient’s nose. So, now that we have a pretty good grasp of what the normal anatomy is, let’s go on to some abnormal anatomy. Remember, we talked
about that nasal mucosa as it was getting inflamed and generating this hyperplastic tissue that we called the polyp. Well, here’s a CAT scan, the same coronal and axial types of images through a patient who
actually has a nasal polyp. You’ll notice some differences
with the prior scan. First off, the maxillary sinus
on this patient’s right side is completely filled
in with material here. It’s hard to know exactly
what that material is. I’ll shade it in over on
this axial image as well. Some of it might be thickened mucosa. Some of it might be mucus. Some of it might actually
be part of a polyp. And here, right up next
to this patient’s septum, you can see this tissue that
wasn’t in the last patient, and this tissue is
actually a part of a polyp. You can see it on the coronal view here, and you can see a portion of it here on the axial view as well. In fact, the patient
probably has another one on this side over here. This one is smaller and
not causing any problems. But this polyp, centered where it is, is actually obstructing the outflow to that maxillary sinus on the right side, and when that happens, mucus will fill up, things will get inflamed,
infections tend to occur, and that’s one of the bigger
problems with nasal polyposis. Mass effect just due to the presence of the actual tissue itself
causes obstruction to things like sinuses, to the tear ducts that
drain into the nose, and to the eustachian
tubes which drain the ears. The tear ducts are up here
at the front of the nose, these are also called nasolacrimal ducts, and the eustachian tube
that runs out to the nose is located at the back. So, you can see if this
particular polyp gets any bigger, this patient runs the risk of obstructing that eustachian tube and causing problems with his middle ear. Going back to our cartoon,
here we’ve drawn a nasal polyp, similar to the one that we
saw on our patient’s CAT scan, but that’s not the only
place they can occur. They can occur up at the
front of the nose here. They can occur down at
the back of the nose here. They can occur at one part of the nose and then extend in a tubular fashion to another part of the nose. Every polyp is a little bit different, and most of the symptoms from these polyps will depend on exactly where they are. So, what can we do about it? Well, there’s a few
things that you should do. The first thing is you should
always try and get rid of what’s causing the inflammation
in the first place. In most cases, that
means treat the allergy. Sometimes that only partially works or might not work at all. In that case, your second line of therapy is often times surgery. Now, while both of these
treatments are good, there is a chance with either one of them that nasal polyps can recur. And some patients may
undergo long treatments to get their inflammation under control or have multiple surgeries
to get rid of the polyps.


23 thoughts on “Nasal polyps | Respiratory system diseases | NCLEX-RN | Khan Academy

  1. I know one thing: I used to be a Surgeon's Technician and I'd rather see brain matter than nasal polyps. Brain matter has always been my one weakness but not because I get grossed out. I can look at anything but I can't always handle what it means. I've almost never seen a person live after their brain matter was exposed to the elements during a trauma, especially high projectile trauma from gunshot wounds, which one of our doctors told us "Is totally preventable. We don't HAVE to have gunshot wounds," he said. Totally annoying the NRA's legal advisors. He had already annoyed them when he said he's going to tell his patients whatever he thinks they need to know and isn't going to feel the need to run it past the NRA first. Not until they get board certified as doctors.
    But nasal polyps plus nasal mucus = too disgusting to look at for long.

  2. hello, how are polyps in CT scans? , What color ?, and the difference between sinusitis and nasal polyps? It is that a doctor examined me and did not find a CT sinusitis, but I check my house and notice a round spot, which appears and disappears in several angles tomography. please help me think it's a nasal polyp.

  3. I'm studying the best treatment for nose polyps and discovered a fantastic website at Jits Polyp Plan (look it up on google)

  4. I've been studying the best natural remedy for reducing nose polyps quickly and found a great website at Jits Polyp Plan (google it if you are interested)

  5. I have spent months investigating the top treatment for nose polyps and discovered an awesome website at Jits Polyp Plan (google it if you are interested)

  6. here's a few suggestions you can try
    buy a saline rinse – this is a good way to keep your nose healthy
    cook with chili peppers – these have a chemical which can reduce nose polyps .
    Use Tea Tree Oil – dilute it and swab the polyps with it – this can reduce polpys and reduce symptoms.
    cosume foods high in anioxidants – broccoli, citrus fruits etc – these help reduce nose polyps naturally.
    (I read these and why they work on jits polyp plan site )

  7. SEE THIS: https://twitter.com/7ead5bu0t9sglfd/status/791912970854948864
    My Nasal Polyps Were Cured and Now I've Been Polyps-Free For 3 Years!

  8. i had a nasal polyp which was quite a size.it was irratating and i flt it hard to breath. i sneezed and it hung out of my left nostril, then i sniffed back up and it went back in my sinus wall. i went to see a ent specialist and was given some nasal spray, i tried it once and it litterally made me feel sick. at that time i startd using cbd products. cannabidiol. this was helping vastly with my anxiety. i was vaping and taking paste..and still continue to do so. anyway after a 3 month period i had to go back to ent to see if i needed surgery.i had the camera up my nostril and the polyp was reduced dramatically, to the point it was hardly visible. All i can say is ive done alot of research on cbd and its is a very strong inflammatory effect and really needs recognised in the medical industry.

  9. A few weeks, my polyps would be 100 % shrunken thanks to the nasal polyps treatment method “Fαfοnzα TD” (Google it) that has been the reason for the fast shrinking of these polyps. I just wished to show my appreciation for your work and commitment in assisting other fellow nasal polyps patients.

  10. Fortunately I found this nasal polyps treatment “Fαfοnzα TD” (Google it), and I instantly started observing advancements. After just a few days with the treatment solution, I didn`t have headaches and stuffy nose anymore simply because the polyps were shrinking noticeably. Right after three weeks the polyps were no longer noticeable and today, 5 months down the road, they have not came back.

  11. Right after following this treatment method for nasal polyps “Fαfοnzα TD” (Google it), I became better. My right polyp is definitely smaller and I could breathe through my nose for the first time in a few months. I am looking to become free from polyps in the future!

  12. When I started using this nasal polyps treatment solution “Fαfοnzα TD” (Google it), I began resting much better and tasting better as well. It took almost Three weeks for her polyps to be gone forever, but it has been worthwhile and that I feel that this system is worth its weight in gold! This is actually the best risk I got, and it absolutely change how I thought my entire life would turn out!

  13. I have been to my doctor this morning and he revealed that there wasn`t any indication of the polyps – and he merely could not believe it! For Eight months, I experienced dreadful headaches even when I had been having topical and oral steroids which claimed to shrink the polyps. Right now, I simply needed to try the nasal polyps treatment method “Fαfοnzα TD” (Google it) for 5 days and now the polyps are gone and I feel happy!

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