Successful prevention of recurrent nasal polyposis by means of systemic low-dose IFN-alpha2a

Long-Term Follow-Up of Cellular Proliferation as a Predictive Index for the Relapse of Nasal Polyposis

Background

The objective of this study was to identify a reproducible clinical parameter for predicting relapses of nasal polyposis after surgery.

Methods

Ninety-three patients who had undergone ethmoidectomy of bilateral nasal polyps were followed for 3 years. Nasal polyps were obtained from all patients, and cellular suspensions were analyzed individually using flow cytometry. Based on the percentage of cells in the S phase, we identified three groups of patients (high, medium, and low percentages).

Results

A relapse of nasal polyposis was observed in 15.00, 70.00, and 100.00% of patients from the low-, medium-, and high-percentage groups, respectively. Patients suffering relapses had a high percentage of cells in the S phase.

Conclusions

We identified two cutoff values for the percentage of cells in the S phase; above the first cutoff, some of the patients suffered relapses; above the second cut-off, all patients suffered relapses.

Woakes' syndrome and albinism

Nasal polyposis is a very common and multifactorial disease. Whereas eosinophil-dominated polyps often are sensitive to anti-inflammatory treatment like corticosteroids, the therapy of polyps without eosinophils is more difficult and disappointing. We report the clinical course of a 29-year-old albino patient suffering from a extreme manifestation of Woakes' syndrome, which is characterized by severe recurrent nasal polyps, often without eosinophils on histological examination and with broadening of the nose. In this case, the recurrent fibrotic polyps without eosinophils were resistant to conventional medical and surgical treatment and required further treatment with radiotherapy with awareness of all possible future sequelae. The pathoetiology and treatment of Woakes' syndrome as well as of albinism were discussed.