Sinonasal Polysis

Nasal polyps are non neoplastic masses of oedematous nasal or sinus mucosa. They are divided into two main varieties
a) Bilateral ethmoid polypi.
b) Antrochonal polyp

Aetiology of nasal polyp is very complex and not well understood. Various diseases associated with the formation of nasal polyp are; Chronic rhinosinusitis, Asthma, Aspirin intolerance, Cystic fibrosis, Allergic fungal sinusitis, few syndromes like Kartagener’s syndrome, Young’s syndrome, Churg-Strauss syndrome. Nasal mucosa, particularly in the region of middle meatus becomes oedematous due to collection of extracellular fluid causing polypoidal change. Polyp usually present as nasal stuffiness leading to total nasal obstruction which can be unilateral or bilateral, partial or total loss of sense of smell, headache, sneezing, postnasal drip, snoring & watery nasal discharge or mass protruding from the nostril.

Diagnosis can be easily made on clinical examination as mass can be seen protruding from nostril but CT scan of paranasal sinuses is essential to exclude the bony erosion and expansion suggestive of neoplasia.

Conservative treatment is used in early polypoidal changes with oedematous mucosa may revert to normal with antihistaminics or short course of steroids. Surgical management includes; Polypectomy, Intranasal ethmoidectomy, Extranasal ethmoidectomy, Transantral ethmoidectomy, Endoscopic sinus surgery.

What are nasal polyps?

Nasal polyps are smooth surfaced, fleshy masses extending into nasal cavity. They may arise from maxillary sinus where it is called antrochoanal polyp or from ethmoidal sinuses where it is called ethmoidal polyp. Nasal polyps can be diagnosed on general head light ENT examination. A CT scan confirms the diagnosis and provides the details of sinuses involved and helps in planning the treatment.

What are the symptoms of nasal polyps?

Polyp usually present with nasal stuffiness leading to total nasal obstruction, partial or total loss of sense of smell, headache, sneezing and watery nasal discharge or mass protruding from the nostril.

What is treatment?

Conservative treatment is used in early polypoidal changes with oedematous mucosa may revert to normal with antihistaminics or short course of steroids. Surgical management includes; Polypectomy, Intranasal ethmoidectomy, Extranasal ethmoidectomy, Transantral ethmoidectomy, Endoscopic sinus surgery.