Acquired pathology  but it is not excluded that predisposing genetic factors exist. Chronic inflammation of the paranasal sinuses is associated with polyps. There are polyps of eosinophilic origin (where an allergic reaction causes the inflammation: respiratory allergy, asthma, aspirin) and polyps of non-allergic origin (cystic fibrosis, ciliary dyskinesia, Kartagener syndrome...)

Woakes syndrome by definition includes:

-        a recurrent nasal polyposis

-        a gradual broadening of the base of the nose as a result of the pressure and the bone erosion due to the growth of the polyps

-        a dyscrinia: production of a highly viscous nasal mucus

-        sometimes a necrotizing ethmoiditis

-        an aplasia of the frontal sinus

-        bronchiectases

Treatment: endoscopic surgery of the sinus, rhinoseptoplasty

Anesthetic implications:

Chest XRay: presence of bronchiectases ?; pre-and postoperative respiratory physiotherapy; risk of posterior nasal discharge with risk of aspiration of that fluid during induction. avoid any compression on the nose with the face mask (induction and awakening):  risk of fracture and bleeding

References:

-        Kellerhals B, de Utheman B.
Woakes’ syndrome : the problems of infantile nasal polyps.
Int J Pediatr Otorhinolaryngol 1979; 1: 79-85

-        Caversaccio M, Baumann A, Helbling A.
Woakes’ syndrome and albinism.
Auris Nasus Larynx 2007; 34: 245-8

-        Choi SR, Kim JH, Chae KL, Lee SC, Park SY.
Anesthetic considerations during surgical intervention in Woake’s syndrome.
Kor J Anesth 2019; 72: 265-9..

Updated: August 2019