What Are Causes of Nasal Polyp Formation ? How To Treat It ?

There are no recent guidelines on intra- or post-operative bacteriological sampling in nasal polyposis. Several studies, how¬ever, showed the interest of screening for immune deficiency and of directed antibiotic therapy when atypic bacteria  are isolated.

In the recent study, the rate of anaerobic bacteria may have been underestimated due to using swabs without transport medium, preventing isolation and culture of anaerobic strains. Busaba, in ethmoid specimens from 179 patients, found rates of 18% for Staphylococci and 24.6% for GNB . Doyle et al. reported comparable rates, notably with 38.9% GNB . The present study found generally similar rates: 27.3% S. aureus and 30.5% GNB, raising the question of their involvement in the onset and development of nasal polyposis.

This study improved the description of the microbial ecology of the ethmoid cavities in nasal polyposis. Functional score in terms of postoperative rhinorrhea, nasal obstruction, anosmia and pain did not significantly differ according to negative, mono- or multi-bacterial culture or according to the type of bacteria isolated.

Most studies in the literature focused on the relation between nasal polyposis and S. aureus. The present study, however, found high rates of pathogens other than the 27.3% rate of Staphylococcus, and notably a 30.5% rate of GNB, raising the question of their role in the onset and progression of nasal polyposis.
This question remains unclarified; studies are needed to spec¬ify the role of SAgs, the cytokines involved in the inflammatory cascade, and the role of bacteria in the phenotypic progression of nasal polyposis and implications for therapy.

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