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Nasal Polyps

Sheraz Ahmed

Page 2

Topics

Symptoms

  1. Nasal obstruction
  2. Nasal discharge
  3. Impaired sense of smell
  4. Feeling of fullness in the face
  5. Headache
  6. Facial pain

Signs

On anterior Rhinoscopy

  1. Polypi appear as smooth glistening grape like masses often pale in color.
  2. They may be sessile or pedunculated.
  3. Insensitive to probing.
  4. Don’t touch on bleeding.
  5. Nasal cavity may show purulent discharge due to associated sinusitis.

On Posterior Rhinoscopy.

Only to see the polyp are visible in posterior nares or not.

Differential Diagnosis of Mucosal Polyp

  1. Antrocoanal polyp
  2. Neoplastic lesions of nose.
  3. Nasal obstruction
  4. Maggots
  5. D.N.S.
  6. Rhinoliths
  7. Hypertrophy of turbinates
  8. Cystic middle turbinate.

Staging of Mucosal Polyp

The advantages of nasal endoscopy and imaging of sinuses make it possible to create a new classification based on morphologic data.

There is 4 stage grading system for nasal polyps of ethmoid based on endoscopic aspect supplemented by C.T. scan and acoustic rhinometry.

  1. STAGE 0=Equivalent to normal mucosa.
  2. STAGE 1=Mucosal swelling in middle meatus.
  3. STAGE 2=Polyps not extending the middle meatus.
  4. STAGE 3=Polyps may involve the middle turbinate.
  5. STAGE 4=All nasalstructures may be involved.

Investigations

  1. Blood C.P. (TLC, DLC, ESR, Hb % and platelets.)
  2. Blood sugar (to exclude the diabetes )
  3. Blood urea (to access the renal function )
  4. Urine D. R.
  5. X-Ray of sinuses
  6. Anterior rhinoscopy
  7. Posterior rhinoscopy
  8. C.T. Scan
  9. M.R.I.
  10. Acoustic rhinometry
  11. Nasal endoscopy

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