Intranasal Mass Flashcards
Benign intranasal mass
- Juvenile nasopharyngeal
- Inverted papilloma - Schwannoma
Malignant intranasal mass
Squamous cell carcinoma
A benign lesion histologically characterized by vascular endothelium–lined spaces embedded in a fibrous stroma that typically affects young male adolescents
Juvenile Nasopharyngeal Angiofibroma
Unilateral nasal obstruction and epistaxis: heralding symptoms
Juvenile Nasopharyngeal Angiofibroma
A.K.A Schneiderian papilloma
Inverted Papilloma
Second most common benign tumor of the sinonasal tract after osteoma
Inverted Papilloma
A.K.A Schneiderian papilloma, inverted type
Unilateral nasal obstruction with watery rhinorrhea is the most common symptom
Histologic appearance:
Hyperplastic ribbons of basement membrane–enclosed epithelium
Inverted Papilloma
A.K.A Schneiderian papilloma, inverted type
Non-neoplastic masses of edematous nasal or sinus mucosa.
Nasal Polyp
Various disease associated with the formation of nasal polyps:
Chronic Rhinosinusitis
Asthma
Aspirin intolerance
Cystic fibrosis
Allergic fungal sinusitis
Hadley’s clinical scoring system of nasal polyposis
Grade 1: smallest size polyps within the middle meatus not reaching the inferior edge of the middle turbinate).
Grade 2: polyps within the middle meatus reaching the inferior border of the middle turbinate.
Grade 3: polyps extending into the nasal cavity below the edge of the middle turbinate but not below the inferior edge of the inferior turbinate.
Grade 4: polyps filling up the nasal cavity
Lund and Mackay’s Nasal Polyps Grading System
Grade 0: no visible polyps
Grade 1 (mild): small polyps confined to the middle meatus (not reaching the lower edge of the middle turbinate)
Grade 2 (moderate): medium-sized polyps extending between the upper and lower edges of the inferior turbinate
Grade 3 (severe): large polyps extending below the lower edge of the inferior trubinate
Differences between antrochoanal and ethmoidal polypi
Look at PPT
Some important points to remember in a case of nasal polyp:
If a polyp is red and fleshy, friable and has granular surface, especially in older patients, think of malignancy.
MALIGNANCY OK
A simple polyp in a child may be a __ & __ or __.
It should always be aspirated and fluid examined for CSF.
Careless removal of such polyp would result in __ & __
glioma, and encephalocele or meningoencephalocele
CSF rhinorrhea and meningitis
Multiple nasal polyp in children may be associated with __
mucoviscidosis
