Current Concepts on the Pathomechanisms of Chronic Rhinosinusitis and Nasal Polyps

Abstract

Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the upper airway subdivided into CRS with or without nasal polyps. CRS with or without nasal polyps is characterized by the infiltration of inflammatory cells, predominantly eosinophils or neutrophils and mast cells and T cells and inflammatory mediators, adhesion molecules, and matrix metalloproteinases. CRS without nasal polyps is more neutrophilic in nature, whereas CRS with nasal polyps especially when associated with aspirin sensitivity, asthma, or allergy is more often eosinophilic in nature. Remodeling like squamous metaplasia, basement membrane thickening, collagen deposition, hyperplasia of mucus glands and goblet cells are features found in both the subgroups of CRS. © 2010 Springer-Verlag Berlin Heidelberg.