NASAL POLYPS Flashcards
Bilateral ethmoidal polyps are common in _________
adults
Antrochoanal polyps are common in __________
children
What is the etiology of ethmoidal polyps?
Rhinosinusitis
Disorders of ciliary motion
Abnormal composition of mucus
Write the causes of ethmoidal polyps in detail.
Chronic rhinosinusitis (NARES)
Asthma
Aspirin intolerance
Cystic fibrosis
Allergic fungal sinusitis
Kartagener syndrome
Young syndrome
Churg Strauss syndrome
Nasal mastocytosis
What are the causes of Antrochoanal polyps?
Infection
Allergy
D/Ds of polyps
Blob of mucus
Hypertrophied middle turbinate (hard and pink)
Angiofibroma (easily bleed on probing)
Neoplasm
How to diagnose polyp?
X-ray PNS
CT contrast PNS
Number of polyps
Ethmoidal =?
Antrochoanal =?
Ethmoidal = Multiple
Antrochoanal = Solitary
Origin of Antrochoanal poylps
Maxillary ostium near the ostium
Origin of Bilateral Ethmoidal polyps
Ethmoidal sinus, uncinate process, middle turbinate, and middle meatus
Why is Antrochoanal poylp missed on anterior rhinoscopy?
It grows backward to the choana. It may hang down behind the soft palate
How do ethmoidal polypi grow?
Mostly grow anteriorly and may present at the nares
Size and shape of Antrochoanal polypi
Antral part
Nasal part
Choanal part (protrude through the choana and obstruct both sides)
Size and shape of Bilateral ethmoidal polypi
Small and grape-like masses
Recurrence of antrochoanal polyp is ___________
uncommon if removed completely
Recurrence of ethmoidal polyp is ____________
Common
What are the symptoms of ethmoidal polyps?
Obstruction
Loss of smell
Headache
Sneezing
Discharge
What are the symptoms of antrochoanal polypi?
unilateral obstruction
Thick voice - hyponasality
Discharge
What are the signs of ethmoidal polypi?
Broadening of the nose
Do not bleed on touching
Increased intercanthal distance
What are the treatment options for antrochoanal polypi?
Polypectomy
Endoscopic removal
Caldwell Luc operation
What are the treatment options for bilateral ethmoidal polypi?
Polypectomy
Endoscopic surgery
Ethmoidectomy (intranasal, extranasal, or transantral)
Some important points to remember in Nasal polyps
Red, fleshy, friable granular in elder (CA risk)
Epistaxis (CA risk)
Orbital symptoms (CA risk)
Examine it for CSF as it can be encephalocele or meningoencephalocele
