**5.2 REAHs associated to a nasal polyposis often previously operated also called REAH-like lesions**

This is the second clinical pattern of REAHs, and certainly this is the most common type.

**Table 2** reports a cohort of 16 patients diagnosed with such a pattern during the past 18 months.

All the patients suffer from a nasal polyposis. In two cases it was a massive primary polyposis. The other patients have a nasal polyposis operated in the past.

Aig; Ph. M Recurrentpolyposis/allergic rhinitis/aspirin intolerance/:metabisulfite intolerance

Corl. W. M Primary severe nasal polyposis: no asthma: operated in 2013/REAHs

Eight patients have concomitant asthma. Two patients have aspirin intolerance.

Chronic inflammation plays a role in the development of REAHs in this clinical

REAHs are located in the olfactory cleft. Their macroscopic aspect is different than usual nasal polyps extruding from the ethmoid sinus. They are more fleshy and

As the following pictures show, it is extremely difficult to differentiate with the fibroscopy REAHs and inflammatory polyps in case of recurrent nasal polyposis. The histologic examination of the surgical specimens is mandatory for this differ-

CT imaging findings are described in only a limited number of studies [1, 4, 5, 14]. Lima et al. [5], Hawley et al. [4], and Lee et al. (51 cases) [14] conclude that REAHs cause widening of the olfactory cleft more than 10 mm but generally do not

All the paranasal sinus cavities can be opaque as illustrated by the following

Some patients have a long-standing disease; REAHs develop after the surgery with time. Some of them are attached to the anterior and superior portion of the

The REAHs were diagnosed at the revision surgery.

**Patient Sex Disease/surgery**

*DOI: http://dx.doi.org/10.5772/intechopen.90327*

S. Jac. M Asthma/rev surgery: REAH-like X2/draf III

Fris. JL M Polypose XZ/revision ethmoidectomy/REAH: chronic otitis media Ros. G M Recurrent NP/asthma: REAHs/rev ethmoidectomy Hub. S. M Sever NP/complete ethmoidectomy

*REAHs and REAH-Like Lesions: Underdiagnosed lesions Often Misconfused with Nasal Polyps*

L.; Th. M Asthma: seromucous otitis media/revision surgery/REAH

Br. Cl. M Aspirin intolerance; asthma/recurrence De Ras.Ge. M Nasal polyposis and asthma /previous surgery Bran. Ar M Revison surgery for massive polyposis De pl. Ph M Nasal polyposis operated 3 times/no asthma Hou. Adr. M Recurrentpolyposis/rev ethmoidectomy

Mas. Cl F Revision surgery/asthma/aspirin intolerance

Tri. Fr. M Ethmoidectomy 10 y ago/nasal polyposis/ REAHs V. Mo F Nasal polyposis /asthma/previous FESS/REAHs X2

Two patients have allergic rhinitis.

*Cohort of patients with REAH-like lesions.*

pattern.

**Table 2.**

*5.2.2 Nasal endoscopy*

firm. There is no necrosis.

entiation (**Figure 19**).

cause bone erosion.

pictures (**Figures 20–22**):

*5.2.3 Imaging*

**65**
