NOSE - Antrochoanal Polyp

What is Antrochoanal nasal polyp?

Antrochoanal nasal polyp is a prolapsed, pedunculated, painless, pearly white oedematous nasal mucosa, lining the nose and maxillary sinuses.

What is the incidence of antrochoanal nasal polyp?

  • Age: Antrochoanal nasal polyp is common in children
  • Sex: Males are more affected than females

What are the causes of antrochoanal nasal polyp?

  • Infection: Antrochoanal polyps have infective aetiology
  • Other theories:
  • Bernoullis phenomenon due to negative pressure
  • Polysaccharide changes of ground substance
  • Vasomotor imbalance

What is the pathology of antrochoanal nasal polyp?

The polyp can extend into the nasopharynx and oro pharynx as it enlarges. It has an antral part, a choanal part and a nasal part. The choanal part in the largest.

What are the symptoms of antrochoanal nasal polyp?

  • Nasal obstruction: It is usually unilateral not relieved by nasal decongestant drops.
  • Nasal discharge: It is unilateral, mucupurulent and occasionally blood tinged.
  • Post nasal drip: It is present and mucopurulent in nature.
  • Many patients come to the specialist with a chronic cold ,quite unaware that they may be having an antochoanal polyp

What are the signs of antrochoanal nasal polyp?

  • Rhinolalia clausa: Present due to nasal obstruction.
  • Broadening of nasal bridge.

What investigations are required to be done for antrochoanal nasal polyp?

  • X-ray of Paranasal Sinuses: This will show the extent of the disease in the sinuses. A polyp seen as a soft tissue shadow in maxillary sinus with convexity upwards.
  • CT Scan of the Paranasal Sinuses: This is the investigation of choice, prior to surgery . CT Scan reveals the extent of the disease, orbital involvement, vascularity , and also altered anatomy in
    previously operated patients.

What is the treatment of Antrochoanal nasal polyp?

  • Medical Treatment: Not much useful in antrochoanal polyp. Antibiotics, decongestants, analgesics can be used along with surgical treatment.
  • Surgical Treatment: Functional Endoscopic Sinus Surgery (FESS). It is the treatment of choice and can be done along with microdebridor.
  • Caldwell Luc Surgery: Rarely done now a days. Performed only for recurrent antro-choanal polyposis.

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