Larsen Per L, Tos Mirko
Departments of Otolaryngology, Gentofte Hospital, University of Copenhagen, Denmark.
Laryngoscope. 2004 Apr;114(4):710-9. doi: 10.1097/00005537-200404000-00022.
OBJECTIVES/HYPOTHESIS: To further elucidate the natural history, etiology, and pathogenesis of nasal polyps, the present study of their anatomical site of origin was undertaken. The possibility for preferred areas or certain patterns in the places of origin was also considered.
Autopsies were examined consecutively.
Endoscopic examination of the nasal cavity and paranasal sinuses, including endoscopic sinus surgery, was performed in 69 autopsies. The place of origin and attachment of each polyp was meticulously described. Polyps were photographically documented in situ and removed, together with the corresponding mucosa, for later histological examination. The cause of death of the patients was either cardiopulmonary disease or malignant diseases. Median age was 73 years (age range, 47-94 y).
Nasal polyps were found in 22 of the 69 autopsies, corresponding to a frequency of 32%. In all, 54 polyps were found. Thirty-nine polyps were small (length, 2-5 mm), 10 were medium-sized, and 5 were large. No complaints of symptoms from the nasal polyps were registered. Most of the polyps (40 of 54 [74%]) originated in relation to sinus outlets. Most of these (34 of 54 [63%]) were found in the middle or superior meatus (13 of 54 [24%]).
The results seemed to indicate that the frequency of nasal polyps is high and that most of the polyps originate from the mucosa of the ostia, clefts, and recesses in the ostiomeatal complex where the initial stage of sinonasal polyposis seems to take place. Continuous postmortem studies in autopsy materials and systematic endoscopic examinations for "silent," asymptomatic nasal polyps in various groups of patients will lead to a better understanding of the natural history of nasal polyps.
目的/假设：为进一步阐明鼻息肉的自然病史、病因及发病机制，开展了本关于鼻息肉起源解剖部位的研究。同时也考虑了鼻息肉起源部位存在偏好区域或特定模式的可能性。
连续进行尸检。
对69例尸检进行鼻腔和鼻窦的内镜检查，包括内镜鼻窦手术。仔细描述每个息肉的起源部位和附着情况。息肉在原位拍照记录，然后连同相应的黏膜一并切除，以备后续组织学检查。患者的死因是心肺疾病或恶性疾病。中位年龄为73岁（年龄范围47 - 94岁）。
69例尸检中有22例发现鼻息肉，发生率为32%。共发现54个息肉。39个息肉较小（长度2 - 5毫米），10个为中等大小，5个为大息肉。未记录到鼻息肉引起的症状主诉。大多数息肉（54个中的40个[74%]）起源于鼻窦开口处。其中大多数（54个中的34个[63%]）位于中鼻道或上鼻道（54个中的13个[24%]）。
结果似乎表明鼻息肉的发生率较高且大多数息肉起源于窦口鼻道复合体的开口、裂隙及隐窝处的黏膜，此处似乎是鼻 - 鼻窦炎鼻息肉病的初始发生部位。对尸检材料进行持续的死后研究以及对不同患者群体中“无症状”鼻息肉进行系统的内镜检查，将有助于更好地理解鼻息肉的自然病史。
