1. History of Nasal polyposis Dr T Balasubramanian

2. Introduction

Nasal polypi first reported 4000 years ago

3. Egyptians were pioneers in diagnosis & trt of nasal polypi 4. Egyptians were familiar with nasal anatomy as they used this route to suck out the brain contents during mummification procedures 5. Samuel of Egypt described a large polyp hanging in the throat strangulating a patient 6. Contribution of Hippocrates

Father of Rhinology

7. Coined the term polyp 8. This term was used because they resembled sea polyp 9. First described the surgical procedure to remove nasal polypi Nasal polyps are sacs of phlegm that cause nasal obstruction and deranges the sense of smell Hippocrates 10. Etiopathology

1 stCentury AD Celsus documented nasal polypi enlarged in size during moist weather

11. Celsus hypothesized nasal polypi to be local manifestation of systemic disorder 12. Boerhaave hypothesized nasal polyp to be elongated nasal mucosa - 17 thcentury 13. Mann & Heister Nasal polypi are formed due to obstruction of mucosal glands A Nasal polyp shows itself by bad smell of the nose Samuel 14. Billroth hypothesis

Billroth demonstrated that nasal polypi microscopically resembled nasal mucosa

15. He also postulated nasal infections somehow could play a role in the genesis of polypi 16. In his classic treatise published in1843 he concluded that nasal polypi couldbe nothing but hypertrophic nasal mucosa 17. Virchow's hypothesis

Considerednasal polyp to be primary tumors like fibroma / myxoma

18. Stressed on the relationship between the age of occurence and nasal deformity 19. Eggston's theory

Nasal polypi are formed due to vascular changes in the submucosal blood vessels

20. These changes are caused by inflammation and periphlebitis 21. The passive oedema of nasal mucous membrane is caused by venous stasis 22. Burn's theory

Also known as mucopolysaccharide theory

23. Mucopolysaccharides present in the stroma could somehow play a role in the pathogenesis of nasal polypi 24. Stromal mucopolysaccharides under go changes in response to allergy and nasal mucosal inflammation causing the mucosa to swell 25. Berden's theory

Nasal polypi could be caused due to allergic inflammation of nasal mucosa

26. He was able to demonstrate the reagin responsible for inflammation of nasal mucosa 27. Allergic reactions involving the nasal mucosa caused mucosal oedema 28. Syndromes associated with nasal polyp

Lurie described the association between nasal polypi and cystic fibrosis in 1959

29. Samter & Beer described the classic samter's triad in 1969. 30. Components of samter's triad include nasal polypi, aspirin hypersensitivity and bronchial asthma 31. Instruments used to examine the nasal cavity

Hippocrates designed a tubular nasal speculum inspired by the speculum designed by Hindu surgeons of yesteryears

32. Hildanus designed the currently available nasal speculum.Hildanus speculum underwent different modifications to evolve into its present form 33. Morrel Mecenzie used mirrors to reflect sunlight to examine the nasal cavity 34. Medical Management

Hippocrates used tampoons dipped in honey and pepper

35. Celsus used caustic agents to treat nasal polypi 36. Galen used oil of turpentine to treat nasal polyp 37. Daniel Bovet used antihistamines in the treatment of nasal polypi for the first time 38. Surgical management

Rolando of Italy used strings with knots to remove nasal polypi

39. Hippocrates described a method of removing the nasal polypi and delivering it via the post nasal space by using a large tampoon which can be pushed into the nasal cavity there by dislodging the polypi 40. Thank you