International Rhinologic Society Rhinology 0300-0729 2026 06 01 The elongated ciliated cells derived from nasal polyps are distinctly different from ciliated cells in different parts of the nasal mucosa EN H. Deng Department of Otorhinolaryngology-Head and Neck Surgery, Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China M. Pang Department of Otorhinolaryngology-Head and Neck Surgery, Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China Q. Yang Department of Otorhinolaryngology-Head and Neck Surgery, Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China H. Qiu Department of Otorhinolaryngology-Head and Neck Surgery, Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China Journal Article 3469 10.4193/Rhin25.225 BACKGROUND: Ciliary abnormalities are implicated in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP), but whether these changes are site-specific traits or confined to specific cell populations remains unknown. Here, we systematically examined ciliated cells throughout the sinonasal tract to characterize disease-specific ciliary alterations and identify a distinct population of elongated ciliated cells in nasal polyps (NPs). METHODS: Nasal biopsy specimens were obtained from patients with CRSwNP (n=32) and non-CRSwNP (n=22). hNECs were differentiated at the air-liquid interface (ALI). Tissue sections, cytospin preparations, and ALI cultures were immunostained for α-tubulin. Cilia length, length of horizontal axis, and length of vertical axis of ciliated cells were recorded. RESULTS: Cilia length was significantly greater in CRSwNP patients than in non-CRSwNP controls (8.17 ± 3.35 μm vs. 5.67 ± 1.64 μm). Within NPs tissues, we identified a distinct population of elongated ciliated cells (ECCs) exhibiting marked inner/outer cilia length disparity, with outer cilia reaching up to 20.0 μm. These ECCs accounted for 8.10% ± 3.56% of total ciliated cells in NPs. Notably, ECCs-like cells were also detected in polypoid-transformed mucosa adjacent to NPs and persisted after ALI culture. In contrast, ciliated cell dimensions did not differ between groups or across the nasal anatomical sites examined. CONCLUSION: A population of ciliated cells characterized by abnormally elongated cilia and concomitant impairment of ciliary function can be found in NPs, which may represent a key pathogenic factor in the development and progression of CRSwNP