Nasal Polyps: An Inquiry into the Mechanism of Formation

Abstract

In a recent essay on nasal polyps, Lederer¹ has called attention to the fact that nasal polyps have been discussed in medical history since earliest times, but that their ubiquity "serves only to remind us how little progress has been made toward the solution of a vexing local manifestation of a constitutional disease." The striking appearance of nasal polyps has attracted many authors, yet attempts at classification have been uncertain; what Semenov² calls their "time-honored terminology" is limited to terms like adenofibroma edematoides or myxoid fibroma, which have only morphological meaning. It seems unlikely that a morphological approach will solve the riddle of nasal polyps. The literature betrays a growing impatience with purely descriptive efforts. General agreement exists that the impairment of homeostasis which causes nasal polyps is marked and prolonged edema of a vulnerable mucous membrane. Lederer quotes Taillens,³ who distinguishes three possible types of edema: