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    Nasal Polyp

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    Hetvi Parmar
    Nasal polyps are growths that develop in the nasal cavity or sinuses. There are two main types: antrochoanal polyps originate in the maxillary sinus and grow backwards, while ethmoidal polyps originate in the ethmoid sinuses and grow forwards. Nasal polyps can cause nasal obstruction, discharge, and loss of smell. Diagnosis involves nasal examination and radiography of the sinuses. Treatment depends on the type but may include medications, polypectomy, or sinus surgery.

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    Nasal Polyp

    Uploaded by

    Hetvi Parmar
    89 views10 pages
    Nasal polyps are growths that develop in the nasal cavity or sinuses. There are two main types: antrochoanal polyps originate in the maxillary sinus and grow backwards, while ethmoidal polyps originate in the ethmoid sinuses and grow forwards. Nasal polyps can cause nasal obstruction, discharge, and loss of smell. Diagnosis involves nasal examination and radiography of the sinuses. Treatment depends on the type but may include medications, polypectomy, or sinus surgery.

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    Nasal polyps are growths that develop in the nasal cavity or sinuses. There are two main types: antrochoanal polyps originate in the maxillary sinus and grow backwards, while ethmoidal polyps originate in the ethmoid sinuses and grow forwards. Nasal polyps can cause nasal obstruction, discharge, and loss of smell. Diagnosis involves nasal examination and radiography of the sinuses. Treatment depends on the type but may include medications, polypectomy, or sinus surgery.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    89 views10 pages

    Nasal Polyp

    Uploaded by

    Hetvi Parmar
    Nasal polyps are growths that develop in the nasal cavity or sinuses. There are two main types: antrochoanal polyps originate in the maxillary sinus and grow backwards, while ethmoidal polyps originate in the ethmoid sinuses and grow forwards. Nasal polyps can cause nasal obstruction, discharge, and loss of smell. Diagnosis involves nasal examination and radiography of the sinuses. Treatment depends on the type but may include medications, polypectomy, or sinus surgery.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 10

    NASAL POLYP

    Nasal polyp is a prolapsed pedunculated part of the


    oedematous mucosa of the nose or paranasal sinuses.

     TYPES OF POLYP: Usually there are 2 types of polyp.

    a) Antrochoanal: It arises from the maxillary antrum &


    grows backwards in the nose towards the choana (posterior
    nares) & reaches the nasopharynx. In advance cases, it may
    reach upto the oropharynx.

    b) Ethmoidal: They are multiple, bilateral and arise


    from the numerous ethmoidal sinuses. They tends to protude
    forwards.
    ANTROCHOANAL POLYP

    ETHMOIDAL POLYPS
     AETIOLOGY:
    1. Age: Antrochoanal polyp usually occur in children and
    young adults. Ethmoidal polyp occurs at any age.
    2. Sex: Both sexes are equally affected.
    3. Predisposing factors –
    a) Allergy may cause polyp.
    b) Vasomotor: The polyp result from the imbalance
    between the sympathetic & parasympathetic nervous
    system in the nose.
    c) Infection may produce polyp which are single or
    multiple.
    d) Mixed: A combination of factors mentioned earlier may
    be responsible for the polyp.
    e) Bernouilli’s phenomenon: When air passes through a
    narrow area in the nose, negative pressure develops in the
    vicinity in the paranasal sinuses leading to increased
    formation of tissue fluids. This may encourage polyp
    formation.
     CLINICAL FEATURES:

    1. Blocking of nose: The nose becomes blocked & is not


    relieved by nasal decongestant drop.
    2. Sneezing is present with allergic polyps.
    3. Discharges: Clear discharge accompanies allergic polyps,
    while purulent discharge may be present with infection.
    4. Expansion of the nose may occur, particularly with chronic
    ethmoidal polyps.
    5. Anosmia is often present.
    6. Snoring & Mouth breathing may occur.
    7. Headache, Epiphora & postnasal drip are rare.
    8. Speech may become hyponasal.
     SIGNS:
    1. External Nose may be broadened in long standing polyps
    giving a frog-like appearance.
    2. Anterior Rhinoscopy: The polyp are smooth, pale, pearly
    white and pulpy. They are painless on touching.
    Antrochoanal polyp may not be visible in the early stage
    as it grows backwards, but it may block the nostril.
    Ethmoidal polyps are bilateral & multiple like bunch of
    grapes. If they protude forwards, they may become pink, or
    become ulcerated.
    3. Posterior Rhinoscopy: Antrochoanal polyp may be seen
    hanging in the nasopharynx. If it is very large, it may be
    visible in the oral cavity as a pear-shaped swelling hanging
    behind the soft palate. Ethmoidal polyp rarely grow
    backward.
    DIFFERENCE BETWEEN ANTROCHOANAL & ETHMOIDAL POLYP

    ANTROCHOANAL POLYP ETHMOIDAL POLYP


    1. Origin Maxillary sinus Ethmoidal sinus
    2. Number Usually single Multiple, Bilateral
    3. Age In children & young adults After puberty
    4. Cause Infection Allergy & infection
    5. Shape Like dumb-bell in second Like grapes
    stage, later trifoliate

    6. Extension Backwards Forwards


    7. Nasopharynx May reach there Unlikely
    8. Recurrence Uncommon if completely Common
    removed

    9. Radiograph Maxillary sinus hazy Ethmoidal sinus hazy


     INVESTIGATION:

    1. Nasal secretion may contain eosinophils in patient having


    polyp due to allergy.
    2. Radiography –
    a) Antrochoanal polyp makes the maxillary sinus opaque
    on the affected side. As the polyp enters the nasal cavity,
    the affected nasal cavity becomes opaque.
    b) Bilateral ethmoidal polyps cause opacity of the
    ethmoidal sinuses & the nasal cavity.
    c) Infection & allergy in other sinuses may produce
    haziness of other paranasal sinuses.
    3. Biopsy confirm the diagnosis.
     DIFFERENTIAL DIAGNOSIS:

    A) Nasal Lesions –
    1. Hypertrophic turbinates
    2. Rhinosporidiosis
    3. Malignancy
    4. Angioma

    B) Nasopharyngeal Lesions –
    1. Adenoids
    2. Nasopharyngal fibro-angioma
    3. Nasopharyngeal malignancy
     TREATMENT:

    1. Antrochoanal Polyp –
    A) Conservative treatment is not very useful for an
    antrochoanal polyp. Antibiotics may be given to control
    infection.
    B) Surgical: The approach is dectated by the age of patient.
    a) Polypectomy
    b) Caldwell Luc operation
    c) Sinoscopy
    2. Ethmoidal Polyp –
    A) Conservative:
    a) Ethmoidal polyp with allergic basis often regress with
    treatment, but may recur.
    b) Antihistamines may be useful for allergic polyp.
    c) Steroids.
    d) Antibiotics are given in combinations with steroids &
    antihistamines .
    e) Decongestants are not of much value.

    B) Surgical:
    1. Polypectomy
    2. Ethmoidectomy
    3. Sinoscopy

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