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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2019; 23(02): 241-249
DOI: 10.1055/s-0038-1676659
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Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Rogerio Pezato 
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Richard Louis Voegels
2   Department of Otolaryngology, USP, São Paulo, SP, Brazil
,
Shirley Pignatari
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Luiz Carlos Gregório
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Thiago Freire Pinto Bezerra
3   Department of Otolaryngology, UFPE, Recife, PE, Brazil
,
Luciano Gregorio
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Leonardo Balsalobre
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Miguel Soares Tepedino
4   Department of Otolaryngology, UERJ, Rio de Janeiro, RJ, Brazil
,
Nathália Coronel
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Fabio de Rezende Pinna
2   Department of Otolaryngology, USP, São Paulo, SP, Brazil
,
José Mendes Neto
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Pedro Oliveira
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Eduardo Macoto
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Renato Stefanini
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Claudia Figueiredo
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Fernanda Haddad
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Renata Pilan
2   Department of Otolaryngology, USP, São Paulo, SP, Brazil
,
Ana Bezerra Soter
2   Department of Otolaryngology, USP, São Paulo, SP, Brazil
,
Nelson Almeida Melo
2   Department of Otolaryngology, USP, São Paulo, SP, Brazil
,
Danilo Almeida Candido
5   Department of Medicine, Nephrology Division, Unifesp, São Paulo, SP, Brazil
,
Jonatas do Amaral
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Rodrigo de Paula Santos
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Thibaut Van Zele
6   Ear, Nose and Throat Department,, University of Ghent, Ghent, Belgium
,
Reginaldo Fujita
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
,
Juliana L. Dreyfuss
7   Department of Biochemistry, Unifesp, São Paulo, SP, Brazil
,
Wallace Chamon
8   Department of Ophthalmology and Visual Sciences, Unifesp, São Paulo, SP, Brazil
9   Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
,
Adriano Mesquita Alencar
10   Laboratory of Microrheology and Molecular Physiology, Institute of Physics, USP, São Paulo, SP, Brazil
,
Claudina Perez-Novo
11   Proteinscience, Proteomics and Epigenetic Signaling, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
,
Aldo Cassol Stamm
1   Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

29 May 2018

21 October 2018

Publication Date:
01 March 2019 (online)

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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.

Keywords

airway - inflammation - nasal mucosa - nasal polyps - sinusitis
 

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