In the name

of ALLAH
Antro - choanal polyp
(killian's Polyp)
Antro - choanal polyp

(killian's Polyp)

It arises from the mucosa of maxillary

antrum near its accessory ostium comes
out if it and grows backwards into the
nasopharynx through the posterior Nares.
 (killian's Polyp) conti

It has three parts

a) Antral part ------which is a thin stalk

b) Choanal part-----Which is round and

globular

c) Nasal part------- Which is flat from side to

side
killian's Polyp) conti

Age: Children and young adults

Number: usually single

Side: Usually unilateral

Sex: equal ratios in two sexes

 Aetiology

1) Nasal Allergy

2) Chronic Sinus infection

3) Retention cyst of mucosa

) gland
 Pathology
1) It is a mucous cyst. due to obstruction
of the duct of one of the mucous
glands in the antrum.

2) It is due to catarrhal protrusion of the

mucosa through the accessory ostium.
Symptoms
1) Usually unilateral

2) males = females

3) No symptoms-when polyp is confined to the antrum

4) Nasal obstruction- constant unilateral nasal

obstruction is presenting symptom.
Obstruction may become bilateral when polyp grows
in nasopharynx.

5) Nasal discharge Watery(allergy)

Mucopurulent(infection)

6) Voice may become thick & dull due to hyponasality .

Symptoms (conti)
1) Rhinolalia clausa

2) Headache----due to sinusitis

3) Snoring

4) Anosmia

5) Conductive deafness: due to blockage of eustachian

tube by the polyp on affected side

6) Dysphagia-if it descends excessively in the pharynx

7) Accumulation of nasal secretions In the nasal cavity

on the affected side as it cannot be blown out
during expiration
Signs
1. Inspection-NAD

2. Palpation-NAD

3. Anterior rhinoscopy :
) Polyp usually not visible .
On vasoconstriction polyp may be
seen in the posterior part of the nasal
cavity & it stack can be traced up to
the middle meatus.
 Signs (conti)
4- Poster Rhinoscopy:
A rounded glistening greyish,smooth avascular
swelling is seen in the posterior narses or protruding
into the nasopharynx through posterior Nares.

5- In advance cases polyp man be hanging in the

oropharynx--- when it will be visible just on opening
the mouth

6- Digital examination
Investigations

1) X-ray PNS on the affected side maxillary sinus

will be totally opaque
2) Blood CP & ESR
3) Urine RE
4) X-ray nasopharynx
lateral view for soft
tissue
5) CT scan Nose
Para nasal sinuses and
Nasophaynx
Differential diagnosis

1) Posterior end of enlarged

turbinate

2) Angiofibroma

3) Malignancy

4) Adenoids
Treatment

1) No medical treatment

2) Polypectomy via nasal route or

through oral cavity if polyp is big and
hanging in the oropharynx/
nasophaynx .
Treatment (conti)

3) In case of recurrence

Caldwel-lucs operation.
Sub-labial approach -canine fossa is opened
and root of polypus along with adjacent
mucous membrane of antrum is removed.
Nasal part of polypus is removed through
the nose or nasopharynx / oropharynx

4) Functional Endoscopic Sinus Surgery (FESS)

( Recently used)
If any question,,,then
most welcome,,,,IF
NO,,,,, Then
ALLAH HAFIZ.