“…Overall, the searching increasing trend was presented in the past decade, which is not only closely associated with the rapid development and wide application of the internet, but may reflect the increasing public interest even or incidence rate of nasal polyps to some extent, although the complete real-world epidemiological study that can reflect incidence rate globally was absent to date. GT analysis can obtain the seasonal variation and geographic distribution information and provide a positive understanding for identifying the influence of geographic distribution and seasonal variation on health information and diseases [ 16 – 18 ], further analyzing both seasonal variation and geographic distribution in search of annual trend was performed in our study, we separately selected the different the northern and southern hemisphere countries who have obviously and no-obvious seasonal variation for identifying the seasonal variations, that included the United States, Australia and Singapore, and results demonstrated and supported the seasonal variation of nasal polyps for the RSV (Fig. 3 ), especially, the peak for the RSV occurred in winter (December–January for the United States, and around July for Australia), the peak for the RSV of seasonal variation may reflect that directly associated with the pathophysiological characteristics and mechanism of NP, actually, for nasal polyps’ formation, which is a result of inflammatory outgrowths of paranasal sinus mucosa following chronic mucosal inflammation, although the pathogenesis is remained unclear, defects in the innate function of the airway epithelial barrier, including diminished expression of antimicrobial products and loss of barrier integrity, combined with colonization by fungi and bacteria likely all were probably contributed to chronic inflammation with elevated expression of many key inflammatory cytokines and chemokines, including IL-5, thymic stromal lymphopoietin (TSLP) and CCL11 in CRSwNP, these factors likely combine to drive the influx of a variety of immune cells, including eosinophils, mast cells, group 2 innate lymphoid cells and lymphocytes, which participate in the chronic inflammatory response within the nasal polyps [ 19 , 20 ].…”