Aetiology
Simple nasal polyps are pedunculated areas of oedematous mucosa occurring in the nasal cavity and paranasal sinuses. Their aetiology is unknown although chronic sinus infection and mucosal allergy have been suggested. Most polyps arise from the ethmoid sinuses with the maxillary antrum being a less common source.
Nasal polyps can be associated with asthma and aspirin sensitivity (aspirin triad). In children, nasal polps may be a manifestation of cystic fibrosis.
Clinical features
Presents as progressive nasal obstruction and rhinorrhea. On inspection of the nasal cavity, polyps are seen as pale grey, smooth swellings, which can fill the nasal cavity. Most cases are bilateral but in unilateral cases a neoplasm must be excluded by biopsy.
An antrochoanal polyp passes from the maxillary sinus via its ostium posteriorly into the nasal cavity to occupy the posterior choana where it can be seen on posterior rhinoscopy and its presence confirmed by lateral radiography.
Management
Medical treatment:
Topical steroid drops or spray administered correctly can cause considerable diminution in polyp size.
Surgical treatment:
Intranasal polypectomy may have to be repeated as recurrence after polyp removal is common. Many surgeons use endoscopic ethmoidectomy techniques to remove polyps from the ethmoid sinuses.
