DEFINITION

This polyp arises from the mucosa of maxillary antrum near its accessory ostium, comes out and grows in choana and nasal cavity.

Thus it has 3 parts

Antral

· Choanal

· Nasal

ETIOLOGY

Nasal allergy coupled with sinus infection is important cause.

These polyps are seen in children and young adults .usually they are single and unilateral.

PATHOLOGY.

2 views about it

1 .It is mucous cyst.

2. It is due to catarrhal protrusion of mucosa through accessory ostium.

SYMPTOMS

1. Unilateral nasal obstruction.

2. Voice may become thick and dull due to hyponasality.

3. Mucoid nasal discharge.

4. Difficulty in chewing and swallowing.

5. Nasal deformity (late cases).

SIGNS

ON ANTERIOR RHINOSCOPY

1. When small, may be missed.

2. When large, smooth greyish mass covered with nasal discharge may be seen.

3. It is soft and can be moved up and down with a probe.

ON POSTERIOR RHINOSCOPY.

1. May reveal globular mass filling the choana.

2. A large polyp may hang down behind the soft palate and present in the oropharynx.

DIFFERENTIAL DIAGNOSIS

1. A blob of mucous often looks like a polyp but it would disappear on blowing the nose.

2. HYPERTROPHIED MIDDLE TURBINATE.

It 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 in 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 occurs then Cald Well –Luc operation may be required to remove the polyp from the site of its origin.