What is Antrochoanal nasal polyp?
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 aetiology
- Other theories:
- Bernoullis 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 oro pharynx as it enlarges. It has an antral part, a choanal part and a nasal part. The choanal part in 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
What are the signs of antrochoanal nasal polyp?
- Rhinolalia clausa: Present due to nasal obstruction.
- Broadening of 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 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 useful in 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 microdebridor.
- Caldwell Luc Surgery: Rarely done now a days. Performed only for recurrent antro-choanal polyposis.