NOSE – Antrochoanal Polyp

What is Antrochoanal nasal polyp?

An 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 etiology

●   Other theories:

●   Bernoulli’s 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 oropharynx as it enlarges. It has an antral part, a choanal part, and a nasal part. The choanal part of 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

●   Rhinolalia clausa: Present due to nasal obstruction.

●   Broadening of the 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 is 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 use in an 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 microdebrider.

●   Caldwell Luc Surgery: Rarely done nowadays. Performed only for recurrent anthro-choanal polyposis.