Chronic rhinosinusitis with nasal polyposis (CRSwNP) is classically considered a type 2 inflammatory disease process of the paranasal sinuses characterized by nasal polyp growth that may be refractory to medical and/or surgical management [1, 2]. Although nasal polyps are called “nasal,” they typically originate from the sinuses and are secondarily prolapsing into the nose. Nasal polyps in the majority of cases are derived from the ethmoidal and maxillary sinus mucosa, but also may grow out from frontal and sphenoid sinus mucosa. They very rarely develop from nasal mucosa including the turbinates. I personally have seen nasal polyps originating in the nose only in specific cases such as patients with Woakes syndrome (massive polyp grow from the nose, sinuses and middle ear mucosa, leading to the broadening of the midface in younger subjects caused by the polyp pressure [3]. The reboot procedure aims to remove the sinus mucosa from the maxillary, ethmoidal, frontal and (if necessary) sphenoidal sinuses bilaterally. The goal is to allow for complete re-epithelialization of the paranasal sinuses by nasal mucosa which has a low potential of developing nasal polyps.

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The Reboot Procedure for Severe Chronic Rhinosinusitis with Nasal Polyps

  • Claus Bachert,
  • Zhang Nan,
  • Philippe Gevaert,
  • Thibaut van Zele

摘要

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is classically considered a type 2 inflammatory disease process of the paranasal sinuses characterized by nasal polyp growth that may be refractory to medical and/or surgical management [1, 2]. Although nasal polyps are called “nasal,” they typically originate from the sinuses and are secondarily prolapsing into the nose. Nasal polyps in the majority of cases are derived from the ethmoidal and maxillary sinus mucosa, but also may grow out from frontal and sphenoid sinus mucosa. They very rarely develop from nasal mucosa including the turbinates. I personally have seen nasal polyps originating in the nose only in specific cases such as patients with Woakes syndrome (massive polyp grow from the nose, sinuses and middle ear mucosa, leading to the broadening of the midface in younger subjects caused by the polyp pressure [3]. The reboot procedure aims to remove the sinus mucosa from the maxillary, ethmoidal, frontal and (if necessary) sphenoidal sinuses bilaterally. The goal is to allow for complete re-epithelialization of the paranasal sinuses by nasal mucosa which has a low potential of developing nasal polyps.