Nasal Polyposis: More than a Chronic Inflammatory Disorder—A Disease of Mechanical Dysfunction—The São Paulo Position

• Main Authors: Rogerio Pezato, Richard Louis Voegels, Shirley Pignatari, Luiz Carlos Gregório, Thiago Freire Pinto Bezerra, Luciano Gregorio, Leonardo Balsalobre, Miguel Soares Tepedino, Nathália Coronel, Fabio de Rezende Pinna, José Mendes Neto, Pedro Oliveira, Eduardo Macoto, Renato Stefanini, Claudia Figueiredo, Fernanda Haddad, Renata Pilan, Ana Bezerra Soter, Nelson Almeida Melo, Danilo Almeida Candido, Jonatas do Amaral, Rodrigo de Paula Santos, Thibaut Van Zele, Reginaldo Fujita, Juliana L. Dreyfuss, Wallace Chamon, Adriano Mesquita Alencar, Claudina Perez-Novo, Aldo Cassol Stamm
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2019-03-01
• Series: International Archives of Otorhinolaryngology
• Subjects: airway; inflammation; nasal mucosa; nasal polyps; sinusitis
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1676659
• ISSN: 1809-9777; 1809-4864

Abstract Introduction The importance of our study lies in the fact that we have demonstrated the occurrence of mechanical dysfunction within polypoid tissues, which promotes the development of polyps in the nasal cavity. Objective To change the paradigm of nasal polyposis (NP). In this new conception, the chronic nasal inflammatory process that occurs in response to allergies, to pollution, to changes in the epithelial barrier, or to other factors is merely the trigger of the development of the disease in individuals with a genetic predisposition to an abnormal tissue remodeling process, which leads to a derangement of the mechanical properties of the nasal mucosa and, consequently, allows it to grow unchecked. Data Synthesis We propose a fundamentally new approach to intervening in the pathological process of NP, addressing biomechanical properties, fluid dynamics, and the concept of surface tension. Conclusion The incorporation of biomechanical knowledge into our understanding of NP provides a new perspective to help elucidate the physiology and the pathology of nasal polyps, and new avenues for the treatment and cure of NP.