Nasal polyp: Difference between revisions
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==Background== | ==Background== | ||
[[File:Paranasal sinuses numbers.png|thumb|Paranasal sinuses: 1. frontal sinuses, 2. ethmoid sinuses (ethmoidal air cells), 3. sphenoid sinuses, 4. maxillary sinuses.]] | |||
*Benign masses filled with inflammatory material that may form in the nasal cavity or paranasal sinuses | *Benign masses filled with inflammatory material that may form in the nasal cavity or paranasal sinuses | ||
*Can be associated with cystic fibrosis in children <ref>Ramsey B, Richardson MA. Impact of sinusitis in cystic fibrosis. J Allergy Clin Immunol. 1992;90(3 Pt 2):547-552. doi:10.1016/0091-6749(92)90183-3 | *Can be associated with cystic fibrosis in children <ref>Ramsey B, Richardson MA. Impact of sinusitis in cystic fibrosis. J Allergy Clin Immunol. 1992;90(3 Pt 2):547-552. doi:10.1016/0091-6749(92)90183-3 | ||
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==Evaluation== | ==Evaluation== | ||
[[File:CHOANAL POLYP PerfectlyClear.jpg|thumb|Large choanal polyp seen with nasal endoscopy.]] | |||
*Physical exam with a nasal speculum or rhinoscope | *Physical exam with a nasal speculum or rhinoscope | ||
*Appear as gray, glistening masses | *Appear as gray, glistening masses | ||
Latest revision as of 05:32, 27 November 2021
Background
- Benign masses filled with inflammatory material that may form in the nasal cavity or paranasal sinuses
- Can be associated with cystic fibrosis in children [1]
Clinical Features
- Nasal airway congestion or obstruction
- Thick nasal discharge
- Anosmia
- May present in patients with chronic rhinosinusitis, asthma, and aspirin sensitivity (in the syndrome of aspirin-exacerbated respiratory disease)
Differential Diagnosis
- Choanal atresia
- Mucocele
- Deviated or dislocated nasal septum
- Hematoma
- Chordoma
- Isolated piriform aperture stenosis
- Nasal dermoid
- Nasolacrimal duct cyst
- Turbinate hypertrophy
Evaluation
- Physical exam with a nasal speculum or rhinoscope
- Appear as gray, glistening masses
- May also be visualized on CT imaging
Management
- Intranasal glucocorticoids are preferred [2]
- Oral glucocorticoids should only be used in severe or refractory cases
- Consider treatment of underlying allergies, antileukotriene agents, and daily saline lavage of the sinuses
- Individuals who fail medical therapy should be considered for surgery
- Surgery may only offer temporary relief as polyps tend to recur after surgery alone
- Continued medical therapy should follow surgery [3]
Disposition
- Discharge, outpatient follow up
See Also
References
- ↑ Ramsey B, Richardson MA. Impact of sinusitis in cystic fibrosis. J Allergy Clin Immunol. 1992;90(3 Pt 2):547-552. doi:10.1016/0091-6749(92)90183-3
- ↑ Newton JR, Ah-See KW. A review of nasal polyposis. Ther Clin Risk Manag. 2008;4(2):507-512. doi:10.2147/tcrm.s2379
- ↑ DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope. 2017;127(3):550-555. doi:10.1002/lary.26391