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Nesepolypper

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
Polyppdannelse (utposning) av betent og ødematøs slimhinne i nese eller bihuler som er klart relatert til kronisk rhinosinusitt
Forekomst:
Prevalens er ca. 5%
Symptomer:
Starter vanligvis med nesetetthet. Etter hvert munnpusting, manglende luktesans, snorking, nasal stemme og hodepine
Funn:
Nesepolyppene er gråbleke, oftest glatte, mer eller mindre stilkede, væskefylte dannelser, som regel multiple og bilaterale
Diagnostikk:
Tilleggsundersøkelser kan være røntgen, CT, nasal endoskopi
Behandling:
Primærbehandlingen er medikamentell og i første rekke rettet mot årsaken til betennelsen, f.eks. sanering av bihuler, antiallergisk behandling. Senere ev. kirurgi
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  10. Vaidyanathan S, Barnes M, Williamson P, et al. Treatment of chronic rhinosinusitis with nasal polyposis with oral steroids followed by topical steroids: a randomized trial. Ann Intern Med 2011; 154: 293-302. Annals of Internal Medicine  
  11. Gevaert P, Calus L, Van Zele T, et al. Omalizumab is effective in allergic and nonallergic patients with nasal polyps and asthma. J Allergy Clin Immunol 2012. doi:10.1016/j.jaci.2012.07.047 DOI  
  12. Chong LY, Piromchai P, Sharp S, et al. Biologics for chronic rhinosinusitis. Cochrane Database Syst Rev. 2020 Feb 27;2:CD013513. doi: 10.1002/14651858.CD013513.pub2 DOI  
  13. Han JK, Bachert C, Fokkens W, et al.; SYNAPSE study investigators. Mepolizumab for chronic rhinosinusitis with nasal polyps (SYNAPSE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med. 2021 Oct;9(10):1141-1153. Epub 2021 Apr 16. PMID: 33872587.
  14. Felleskatalogen. Dupilumab, omalizumab, mepolizumab, benralizumab. Indikasjoner. Sidene besøkt 20.12.2021. www.felleskatalogen.no  
  15. Bachert C, Han JK, Desrosiers MY, et al. Efficacy and safety of benralizumab in chronic rhinosinusitis with nasal polyps: A randomized, placebo-controlled trial. J Allergy Clin Immunol 2021. pmid:34599979 PubMed  
  16. Sharma R, Lakhani R, Rimmer J, et al. Surgical interventions for chronic rhinosinusitis with nasal polyps. Cochrane Database Syst Rev. 2014 ;11:CD006990. doi: 10.1002/14651858.CD006990.pub2. The Cochrane Library  
  • Ingard Løge, spesialist i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Stein Helge Glad Nordahl, øre-nese-hals spesialist, overlege Haukeland sykehus, Bergen