Fiche publication
Date publication
avril 2018
Journal
European annals of otorhinolaryngology, head and neck diseases
Auteurs
Membres identifiés du Cancéropôle Est :
Pr JANKOWSKI Roger
,
Pr GALLET Patrice
Tous les auteurs :
Jankowski R, Rumeau C, Gallet P, Nguyen DT
Lien Pubmed
Résumé
The concept of chronic rhinosinusitis with or without polyps is founded on the structural and functional unicity of the pituitary mucosa and its united response to environmental aggression by allergens, viruses, bacteria, pollution, etc. The present review sets this concept against the evo-devo three-nose theory, in which nasal polyposis is distinguished as specific to the olfactory nose and in particular to the non-olfactory mucosa of the ethmoid, which is considered to be not a sinus but rather the skull-base bone harboring the olfactory mucosa. The evo-devo approach enables simple and precise positive diagnosis of nasal polyposis and its various clinical forms, improves differential diagnosis by distinguishing chronic diseases of the respiratory nose and those of the paranasal sinuses, hypothesizes an autoimmune origin specifically aimed at olfactory system auto-antigens, and supports the surgical concept of nasalization against that of functional sinus and ostiomeatal-complex surgery. The ventilation function of the sinuses seems minor compared to their production, storage and active release of nitric oxide (NO) serving to oxygenate arterial blood in the pulmonary alveoli. This respiratory function of the paranasal sinuses may indeed be their most important. NO trapped in the ethmoidal spaces also accounts for certain radiographic aspects associated with nasal polyposis.
Mots clés
CT, Chronic rhinosinusitis, Ethmoid, Nasal polyposis, Nitric oxide (NO), Paranasal sinuses
Référence
Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Apr 13;:
