Nasal polyps (&
- Nasal polyps
rarely are seen in children younger
than age 10 years.
- When they do
occur in kids < 10 yo, there is a high
probability of concomitant cystic fibrosis.
- In a large
series of cystic fibrosis patients, approximately 25% had nasal polyps, and
polyps were the initial symptom in approximately 13 of the 605 patients (2%).
usually appear between the ages of 5 and 20 years in
- Nasal polyps
also have been associated with
immotile cilia syndrome.
symptoms that have a sudden onset and worsen steadily are unusual
manifestations of a seasonal allergy in which symptoms generally wax and wane.
polyps and CF: although patients who have cystic fibrosis can have significant
nasal congestion and, in fact, do have nasal polyps, such findings commonly
would be accompanied by gastrointestinal and pulmonary symptoms and growth
failure. It also would be very unlikely for a previously healthy 12-year-old
child to have nasal symptoms as the primary presenting symptom of cystic
examination of a child who has nasal polyps can be both rewarding and
frustrating. If seen, the polyps appear as a
"bag of jelly" or a "grape" obstructing
the nasal passage. Unfortunately, they
tend to be posterior and cannot
be easily visualized with the use of an otoscope in the patient's nasal passage.
Accordingly, affected patients may need
referral to an ENT physician or limited computed tomography of the sinuses for
diagnosis of the polyps.
Slavin RG. Nasal polyps and sinusitis. In: Middleton E Jr, Reed CE,
Ellis EF, Adkinson NF Jr, Yunginger JW, Busse WW, eds. Allergy:
Principles and Practice. 5th ed. St Louis, Mo: Mosby-Year Book, Inc;
Slavin RG. Nasal polyps and sinusitis. JAMA. 1997;278:1849-1854
Sly M. Allergic rhinitis. In: Behrman RE, Kliegman RM, Jenson HB, eds.
Nelson Textbook of Pediatrics. 16th ed. Philadelphia, Pa: WB Saunders