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  • Nasal Polyps: Causes, Symptoms and Treatment

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    Puteri Atiqah Syaqila
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    Nasal polyps are non-cancerous growths that develop in the nasal cavity or paranasal sinuses. There are two main types - ethmoidal and antrochoanal polyps. Symptoms include nasal obstruction, loss of smell, headaches and sinusitis. Examination shows smooth grape-like masses protruding from the nostrils. Treatment involves medical management with steroids and antihistamines or surgical polypectomy or sinus surgery to remove polyps. Recurrence is possible after surgery if the underlying cause such as sinusitis or allergy is not addressed.

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    Nasal Polyp

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    Nasal polyps are non-cancerous growths that develop in the nasal cavity or paranasal sinuses. There are two main types - ethmoidal and antrochoanal polyps. Symptoms include nasal obstruction, loss of smell, headaches and sinusitis. Examination shows smooth grape-like masses protruding from the nostrils. Treatment involves medical management with steroids and antihistamines or surgical polypectomy or sinus surgery to remove polyps. Recurrence is possible after surgery if the underlying cause such as sinusitis or allergy is not addressed.

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    69 views3 pages

    Nasal Polyps: Causes, Symptoms and Treatment

    Uploaded by

    Puteri Atiqah Syaqila
    Nasal polyps are non-cancerous growths that develop in the nasal cavity or paranasal sinuses. There are two main types - ethmoidal and antrochoanal polyps. Symptoms include nasal obstruction, loss of smell, headaches and sinusitis. Examination shows smooth grape-like masses protruding from the nostrils. Treatment involves medical management with steroids and antihistamines or surgical polypectomy or sinus surgery to remove polyps. Recurrence is possible after surgery if the underlying cause such as sinusitis or allergy is not addressed.

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    of 3

    NASAL POLYP| neoplastic masses of oedematous nasal/ sinus mucosa

    TYPES BILATERAL ETHMOIDAL


    AETIOLOGY & PATHOGENESIS Arise in inflammatory conditions of mucosa (rhinitis) Disorder of ciliary motility (cystic fibrosis) Abnormal composition of nasal mucus Disease a/w polyp: o Chronic rhinosinusitis o 7% asthma o 36% aspirin intolerance

    ANTROCHOANAL
    AETIOLOGY & PATHOGENESIS arise from mucosa of ma"illary antrum near its accessory ostium #rows in choanan ! nasal ca$ity& 3 parts: o Antral: thin stal' o Choanal: round ! #lobular o (asal: flat from side to side C" is un'nown (asal aller#y ) sinus inf"*usually in children/ teena#ers +in#le ! unilateral SYMPTOMPS & SIGNS 0nilateral nose bloc' ay be bilateral (polyp #rowth in nasopharyn" ! obstructin# the opposite choana& 2hic' ! dull $oice d/t hyponasality (asal dischar#e (mucoid) 4row posteriorly .f lar#e 5 smooth #reyish mass co$ered w nasal dischar#e +oft ! mo$e up ! down w probe ay protrude out of nostril ! appear pin' con#ested on its e"posed sides 7osterior rhinoscopy shows: a& 4lobular mass fillin# choana ! nasopharyn" b& 7olyp may han# down behind soft palate ! present in oropharyn" TREATMENT :emo$ed by a$ulsion throu#h nasal/ oral route& :ecurrence ab( after complete remo$al

    iddle meatus ! turbinate becomes oedematous d/t e"tracellular fluid collection polypoidal chan#e (sessile pedunculated) d/t #ra$ity ! e"cessi$e snee%in# PATHOLOGY ,pithelium uner#oes a metaplastic chan#e (from ciliated columnar transitional ! s-uamous type) d/t e"posure to atmospheric irritation .ntercellular spaces filled w serous fluid .nfiltration of eosinophils ! round cells&

    /& 1& 3& 3& /& 1& 3& 3& 6&

    SYMPTOMPS & SIGNS Anterior rhinoscopy show /& ultiple (any a#e but mainly adult) 1& (asal stuffiness nasal obstruction 3& 7artial/ total loss of smell 3& 8eadache a/w sinusitis 6& +nee%in#/ watery nasal dischar#e a/w aller#y 6& ass protrudin# from nostril /& 1& 3& 3& 6& 6& 7& Appear smooth9 #listerin#9 #rape li'e mass ! pale in color +essile/ pedunculated .nsensiti$e to probin# Do not bleed on touch ultiple ! bilateral 7rolon#ed 5 broadenin# of nose ! increase intracanthal distance& Apperar pin' d/t $ascular stimulatin# (if protrudin#)

    ;&

    7urulent dischar#e d/t associated sinusitis DIAGNOSIS D" by clinical e"am C2 scan of paranasal sinuses : to e"clude bony erosion/ e"pansion su##estice of neoplasia aybe a/w mali#nancy esp& < 3= yo

    IMPORTANT 7olyp is red ! fleshy9 friable9 has #ranular surface in older pt > mali#nancy +imple nasal polyps may mas' mali#nancy& 2hus A?? polyp should be sub@ected to 87, ,pista"is ! orbital symptoms a/w polyp should arouse suspicion of mali#nancy

    TREATMENT !" CONSER#ATI#E Antihistamine ! aller#ic control (early chan#es mi#ht re$ert to normal) A short course of steroids (for ppl who canAt tolerate antihistamine/ asthma/ pre$ent recurrence after sur#ery) C/. for steroids: 82(9 70D9 D 92B9 7re#nant $" S%RGICAL 7olypectomy .ntranasal ethmoidectomy ,"tranasal ethmoidectomy (polyp recur after ., procedure/ sur#ical landmar's are ill 5 defined) 2ransantral etmoidectomy (when inf" ! polypoidal chan#e seen in the ma"illary antrum) ,ndoscopic sinus sur#ery (most preferred9 called C,++ DCunctional endoscopic sinus sur#eryE

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