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March 1992

Allergy Is Not a Significant Cause of Nasal Polyps

Author Affiliations

St Louis, Mo

Arch Otolaryngol Head Neck Surg. 1992;118(3):343. doi:10.1001/archotol.1992.01880030135028

To the Editor.—Nasal polyps were first described more than 3000 years ago and comprise the most common group of mass lesions encountered in the nose. Despite this long history and frequent occurrence, a great many questions still exist with regard to pathogenicity.

Heading the list of possible mechanisms is allergy. The major features pointing to allergy as a cause of nasal polyps are rhinorrhea, sneezing, itching, elevated histamine and IgE in extracellular polyp fluid, degranulated mast cells in polyps, marked tissue eosinophilia, and association with late-onset asthma. The assumption that allergy does play an important role in the pathogenesis of nasal polyps is certainly evident in clinical practice. The experience of allergists is that many patients with nasal polyps are referred by otolaryngologists for allergy evaluation. It is my impression based on a nonscientific "straw poll" that the majority of otolaryngologists do believe that allergy and nasal polyps are

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