Prevalence and Symptom Burden of Nasal Polyps in a Large Austrian Population

Abstract

Background: Although chronic rhinosinusitis with nasal polyps is a common inflammatory condition with significant morbidity and financial cost, information regarding prevalence and disease burden of this condition is scarce.

Objective: In this study, we determined nasal polyp prevalence, polyp grade, concomitant disease, and symptom burden in more than 10,000 central European subjects.

Methods: In this retrospective, cross-sectional study, 10,259 patients who had undergone routine examination of their nose by nasal endoscopy during a visit at a publicly accessible ear, nose, throat outpatient facility in Vienna were included. Patient details including presenting complaint, nasal symptoms, polyp score, age, gender, treatment, asthma, and allergic status were extracted retrospectively. A detailed questionnaire including history of nasal symptoms, Sino-Nasal Outcome Test-20 German Adapted Version, and visual analog scale was available for 101 patients with nasal polyps.

Results: Nasal polyps were detected in 189 of the 10,259 (1.84%) patients. The calculated prevalence of polyps in Austria, adjusted for age and gender, was 1.95%. The average total polyp score (TPS) was 3.4, and 72.5% had a TPS of ≤4, with males and asthmatics having significantly larger polyps. Questionnaire analysis revealed that 67% suffered from a low symptom burden of ≤36. According to current European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) guidelines, 6% of patients with polyps met and another 8% potentially fulfilled the eligibility criteria for biological therapy.

Conclusion: Nasal polyp prevalence was calculated to be 1.95% of the Austrian population. Large polyps (TPS >4) were found in 25%, 33% suffered from a high nasal symptom burden, and between 6% and 14% of patients with polyps would be eligible for biological therapy according to EPOS guidelines.

Keywords: Asthma; Biological treatment; CRS; CRSwNP; Chronic rhinosinusitis; Disease burden; EPOS; Nasal polyp; Prevalence; Total polyp score.