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Nasal Polyps

Sheraz Ahmed

Page 4

Topics

Differential Diagnosis

  1. A blob of mucous often looks like a polyp but it would disappear on blowing the nose.
  2. Hypertrophied Middle Turbinate – is differentiated with its pink appearance and hard feel of bone on probe testing.
  3. Angiofibroma – has history of profuse recurrent epistaxsis. It is firm in consistency and easily bleeds on probe testing.
  4. Other neoplasm may be differentiated by their fleshy pink appearance, friable nature and their tendency to bleed.

Treatment

  1. An antrocoanal polyp is easily removed by either through the nasal or oral route.
  2. Recurrence is uncommon after complete removal.
  3. If recurrence occur then Caldwell – Luc operation may be required to remove the polyp from the site of its origin.

F: Prevention of Recurrence of Nasal Polyps

Identify the underlying causeof polyps and treat it accordingly.

G: Complications of Nasal Polyps

  1. Nasal obstruction
  2. Insomnia
  3. Sinusitis
  4. Respiratory tract infections
  5. Broadening of nose and increased intercanthal distance
  6. Headache
  7. Facial pain

H: Important Points to Remember in a Case of Nasal Polyps

  1. If a polypus is red and fleshy, friable and has granular surface, especially in older patients, think of malignancy.
  2. Simple nasal polyp may masquerade a malignancy underneath, hence all polypi should be subjected to histology.
  3. A simple polyp in a child may be glioma, an encephalocele or a meningoenccephalocele. It should always be aspirated and fluid examined for CSF.
  4. Multiple nasal polypi in children may be associated with mucovisidosis.
  5. Epistaxis and orbital symptoms associated with a polyp should always arouse the suspicion of malignancy.

References:

  1. Diseases of Ear, Nose and Throat, by P.L. Dhingra. (second edition)
  2. Current Medical Diagnosis and Treatment, 2000.
  3. Textbook of Ear, Nose and Throat, by Abdul Ghani.
  4. Web sites


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