9. Proper clinical and radiologic evaluation should be done in such cases before . It passes through the ostium of the sinus into the choana, and from there into the posterior nasopharynx. This article also discusses the clinical features, pathogenesis, and surgical treatment of this entity. Stammberger H (1986) Nasal and Paranasal Sinus Endoscopy A Diagnostic and Surgical Approach to Pagella F, Emanuelli E, Pusateri A, Borsetto D, Cazzador D, Marangoni R, et al. 72(854 . - Inverted papilloma: irregular lesion at . The two general differential diagnoses are inverted papilloma . 10.2214/AJR.11.7420. The differential diagnosis of ACPs should include juvenile angiofibroma, nasal glioma, meningoencephalocele, inverted papilloma, mucocele, mucus retention cyst, Tornwalt's cyst, grossly enlarged adenoids, lymphoma and nasopharyngeal malignancies ( 1 - 3, 8, 28, 31 ). As such, CT imaging is invaluable in confirming diagnosis of ACP. There are two primary types of nasal polyps: ethmoidal and antrochoanal. angiofibroma. To investigate the length of follow-up needed to detect recurrence of antrochoanal polyps. Differential diagnosis. ACPs should be considered in the differential diagnosis of unilateral nasal obstruction and a nasal mass. Polyps are the most common expansile lesions of the nasal cavity 8.Incidence increases in patients with conditions known to be associated with polyps such as infectious rhinosinusitis, cystic fibrosis, aspirin sensitivity, allergic fungal sinusitis, asthma and nickel exposure 10. diagnosis isdiscussed. Points of Evaluation Endoscopic view of the left middle meatus. Its physiopathology remains unclear. The . Conclusion: Although this entity is rarely seen in daily clinical practice, great care is needed to catch the diagnosis for early treatment to avoid unwanted complications. The antrochoanal polyp, usually asolitary benign growth, arisesfromthemaxillary antrum ofanonatopic patient.
Benign lesions such as mucous retention cyst, antrochoanal polyp, mucocele, Tornwaldt cyst (located in the midline of the nasopharynx), . Ylmaz YF, Titiz A, zcan M, Tezer MS, zlgedik S, nal A.
Keywords: Choanal polyp; superior turbinate; endoscopic endonasal surgery The diagnosis of bilateral antrochoanal polyp was maintained upon clinical, radiological, endoscopic and histological findings. Antrochoanal polyp: 1- Inflammatory polyps 2- diffuse sinonasal polyps. Richard Towbin. India At the end of history a differential diagnosis of nocturnal seizures, narcolepsy, parasomnias and obstructive sleep apnea was made. A suspicion of hemangioma (cavernous/capillary) may arise due to occurrences of recurrent bleeding, but this diagnosis was not supported by radiological findings . Typically, there is extensive vascular proliferation and ectasia . Antrochoanal polyps are the most common type of choanal polyps, representing 4-6% of all nasal polyps in the general population, 3 and commonly occur in children and young adults. Antrochoanal polyp. In order to avoid any recurrence of disease, it is important to choose the best surgical approach for removal of ACP with respect to the site of attachment within the maxillary sinus walls. Differential Diagnosis Thediagnosis ofantrochoanal polyp isstrongly sug-gested whenanopacified maxillary antrum isexpanded andthere isanasopharyngeal mass. The polyp is directly in the center and is pale, glistening, and white. Antrochoanal Polyp. American Journal of Roentgenology, 1979. 2. 2011;197:1309-1321. Discussion: Antrochoanal polyps are inflammatory lesions that cause obstruction of the maxillary sinus ostium with postobstructive sinus opacification. A retrospective cohort study was carried out by analysing a database of 82patients who were . The differential diagnosis includes antrochoanal polyp, hypertrophied adenoids, Thornwaldt cyst pituitary tumours, lymphoma, and carcinoma.5 Treatment During the procedure, by tracing the polyp proximally, we were able to confirm its exit through the ostium of the sphenoid sinus on the left side. It is most commonly encountered in adults and rare in children.
Antrochoanal polyps (ACP) are benign, large, inflammatory polyps which originate from within the maxillary sinus and extend through the natural or accessory ostia, into the nasal . They are well defined and do not typically cause significant sinus expansion. The antrochoanal polyp, usually asolitary benign growth, arisesfromthemaxillary antrum ofanonatopic patient. Investigations: Differential diagnosis: Investigations: Differential diagnosis The state of the art Endoscopy CT:computed tomography [no Plain X-ray] Culture Biopsy Acoustic Rhinometry [anatomy] Rhinomanometry [physiology] Reda Kamel, M.D. DIFFERENTIAL DIAGNOSIS 1. Itgrows byextension from theantrum through . 2000;10(5):849-51. While there are benign unilateral polyp etiologies such as an antrochoanal polyp, the suspicion for malignancy should be high and a referral to an otolaryngologist is indicated for a biopsy. Discussion: Antrochoanal polyps are inflammatory lesions that cause obstruction of the maxillary sinus ostium with postobstructive sinus opacification. Common. Hong SK, Min YG, Kim CN, Byun SW. Endoscopic removal of the antral portion of antrochoanal polyp by powered instrumentation. Simple nasal polyps and antrochoanal polyps were the most common non-neoplastic sinonasal masses in this study forming up to 57(75%). A short summary of this paper. A retention cyst derived from a salivary . diagnosis isdiscussed. Clinical features and management of antrochoanal polyps in children: Cues from a clinical series of 58 patients. Explore the latest full-text research PDFs, articles, conference papers, preprints and more on DIAGNOSTIC METHODS. 2. 8. Diagnosis: Right antrochoanal polyp (ACP) . J Craniofac Surg 2015;26:e661-2. It can be differentiated from antrochoanal polyp by endoscopic examination, CT scan and/or MRI. Pagella F, Emanuelli E, Pusateri A, Borsetto D, Cazzador D, Marangoni R, et al. Most simple inflammatory nasal polyps are classed as chronic rhinosinusitis with nasal polyps, which are bilateral. Antrochoanal polyp should be kept in differential diagnosis when a patient comes with unilateral nasal obstruction and discharge. Though it is commonly seen in young adults, rarely, children . They are well defined and do not typically cause significant sinus expansion. Download Download PDF. desiccated) and/or have an associated fungal infection (see fungal sinusitis) 1. An antrochoanal polyp (ACP) is a benign sinonasal lesion that originates from the mucosa of the maxillary sinus. In the present investigation, 11 patients (68.75%) B-ENT 2007;3:97-9.
3. Antrochoanal polyps represent only 4-6% of all nasal polyps in the general population but account for approximately one third of polyps in the pediatric population. Prognosis: Safe. . A retrospective investigation was performed on . Thus, REAH can be mistaken for inverted papilloma, nasal polyp, antrochoanal polyp, and even with low-grade adenocarcinoma. Although very rare, a CP arising from the superior turbinate must be considered in the differential diagnosis of a solitary nasal polyp. . Laryngoscope 2001; 111(10):1774-8. . Antrochoanal polyps commonly present with nasal obstructive symptoms.2 Rarely, . Nasal presenting symptoms are unilateral obstruction and nasal discharge. Antrochoanal polyp is known to occur in inflamed, edematous mucosa of the maxillary sinus or an accessory ostium.
Other causes of nasal mass lesions, for example, antrochoanal polyp, nasal polyp, encephalocele, and other rare neoplasms: inverted papilloma, squamous cell carcinoma, adenocarcinoma, esthe-sioblastoma, rhabdomyosarcoma; Other causes of orbital swelling or proptosis; Hughes ML et al: Persistent hypophyseal (craniopharyngeal) canal. Methods. The primary differential diagnosis includes inflammatory / allergic polyp, which typically shows more eosinophils and more submucous glands (Acta Otolaryngol 1995;115:543). In this age group, adenoid hypertrophy is a very common finding and the symptoms may resemble those of ACP, like nasal obstruction, chronic rhinorrhea and snoring. Choanal and antrochoanal polyps are often unilateral, and inverted papilloma should always be included in the differential diagnosis. Christopher J. Hanrahan, Lubdha M. Shah. Diagnosis of bleeding nasal mass is varied from benign to malignant lesions. Other possible T1-Weighted Imaging-Based Differential Diagnosis. Antrochoanal polyps in children: CT findings and differential diagnosis. ACPs can be diagnosed by taking a careful history and conducting clinical exam as well as nasal endoscopic and radiological examinations. Acta Otorhinolaryngol Ital. sphenochoanal polyps. Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they extend into the choana. Pruna X, Ibaez JM, Serres X, et al (2000) Antrochoanal polyps in children: CT findings and differential diagnosis. Clinical, histological and radiological differential diagnosis of AAP are antrochoanal polyp, hemangioma, juvenile nasopharyngeal angiofibroma, inverted papilloma and malignancy. The antrochoanal polyp, or Killian's Polyp is a be-nign, solitary lesion that affect mainly children and young . Differential Diagnosis. These polyps have the same characteristic gross findings as ordinary antrochoanal polyps, with the addition of a reddish, vascular surface in some areas, an empty pterygopalatine fossa on CT, and . Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence. The diagnosis of angiomatous antrochoanal polyp is based on gross diagnostic criteria, detected on endoscopic examination and aided by CT scanning. Differential diagnosis The diagnosis of ACP may be challenging, mainly in young children (5-8 years). The inspiratory air current is more powerful than the expiratory air current thereby pushes the polyp posteriorly. These polyps have a discrete male predominance and are diagnosed usually between the third and the fifth decades of life. Eur Radiol 10:849-851. doi: 10.1007/s003300051017. Antrochoanal polyp is a benign lesion originating from the mucosa of the maxillary sinus, growing through the accessory ostium into the middle meatus and, thereafter, protruding posteri- . Severe conductive hearing loss. The polyp opacifies and slightly enlarges the sinus cavity with no bone destruction. The length of follow-up of patients should be for at least 2 years postoperatively in order to detect 95% of recurrence of antrochoanal polyps, which is more common in younger patients than adults and significantly higher in children. . In rare cases, presenting symptoms may be atypical. Why? If present pale, edematous& pedunculated. May pass into choanae or nasopharynx. INVESTIGATIONS Nasal endoscopy May reveal choanal or antrochoanal polyp hidden posteriorly in the nasal cavity Xrays of paranasal sinuses May show opacity of the involved antrum Lateral view xray: globular swelling in postnasal space column of air behind the polyp 22. Magnetic resonance imaging has led to substantial advances in the preoperative differential diagnosis of cholesterol granuloma. The most common type is the antrochoanal polyp, which originates in the mucosa of the maxillary sinus or antrum. Antrochoanal polyp differential diagnoses include ipsilateral nasal tumours such as angiofibroma, nasal glioma, encephalocele, mucocele, retention cyst, inverted papilloma or haemangioma. Unilateral Nasal Polyps. Central or . A diagnosis of left antrochoanal polyp with obstructive sleep apnea was made. Antro-choanal polyp is generally recognized to represent approximately 4-6% of all nasal polyps; however, it is much more prevalent in the pediatric population. Further examination by nasal endoscopy, computerized tomography, and histopathological evaluation of the excised polyp have confirmed the diagnosis of an antrochoanal polyp. 3. Benign lesions of the maxillary sinus can be conveniently divided into nonneoplastic and neoplastic . A suction is visible on top of the inferior portion of the uncinate process and inferior portion of the polyp. SAP is believed to be a derivative of the antrochoanal polyp. The antrochoanal polyp has a liquid component. They occur more commonly in children and young adults, and they are almost. It is estimated that between 0.2% and 1% of the population will develop nasal polyps at some time; the incidence of nasal polyps increases with age.
Epidemiology. These polyps were classified grade III according to Chung et al.'s classification [ 6 ]. If present reddish, fleshy & sessile. Differential Diagnosis & Pitfalls. 5 Several possible mechanisms, . Arise from wall of maxillary antrum, extending through large primary or secondary maxillary ostium into nasal cavity. 4 Polyp extension . . Solitary polyps of the uncinate process To the best of our knowledge, no case of a sphenochoanal polyp with concomitant obstructive sleep apnea has been reported, and only 2 cases (13,14) of an antrochoanal polyp . The polyp may then extend posteriorly toward the choana and sometimes into the nasopharynx. mors, which would serve as differential diagnosis. Differential Diagnosis: Antrochoanal polyp, inverting papilloma, minor salivary gland neoplasm, chronic sinus disease. Differential diagnosis: - Angiofibroma: usually manifests itself with symptoms of nasal obstruction and repeated episodes of epistaxis. Sphenochoanal polyps arise from the sphenoid sinus and pass through choanae to nasopharynx. Radiographic examination with CT-scan and more rarely MRI helps the diagnosis.
Reference Lee, Yoon, Lee and Lim 11, Reference Lee and Huang 12. Bilateral antrochoanal polyps in an adult: a case report. Antrochonal polyp is a unilateral and benign tumor of the maxillary sinus occurring in children. In both cases, the diagnosis was done by nasal endoscopy and computed tomography (CT) of the paranasal sinuses and supported by Differential diagnosis of primary nasopharyngeal lymphoma and nasopharyngeal carcinoma focusing on CT, MRI, and PET/CT. 2 Due to its relatively deep seated location, it results in a late presentation. Clinical features and management of antrochoanal polyps in children: Cues from a clinical series of 58 patients. Ossicles: Usually intact Usually necresed Hearing loss: Mild conductive hearing loss. The antrochoanal polyp, a benign solitary polypoid lesion, usually arises in a maxillary sinus, opacifying and enlarging the sinus cavity without bone destruction. 4 - 6% of nasal polyps. A suction is visible on top of the inferior portion of the uncinate process and inferior portion of the polyp. Although pathologically antrochoanal polyps have a narrow pedicle or stalk, this is usually not evident on CT.
Pruna X, Ibanez J, Serres X, Garriga V, Barber I, Vera J. Antrochoanal polyps in children: CT findings and differential diagnosis. De Vuysere S, Hermans R, Marchal G. Sinochoanal polyp and its variant, the angiomatous polyp: MRI findings. turbinate hypertrophy. It grows by extension from the antrum through its ostium. [7] Antrochoanal polyps. A choanal polyp is a benign solitary sinonasal mass that originates in a paranasal sinus and secondarily extends into the nasal cavity. Full PDF Package Download Full PDF Package. differential diagnosis for cystic lesions of the aerodigestive tract and present and an algorithmic, anatomically -based diagnostic approach . Find methods information, sources, references or conduct a literature review on . Polysomnography was not available and could not be done to document obstructive sleep apnea. Br J Radiol. Consequently, the differential diagnosis is crucial in this entity.
Antrochoanal polyp (Killian polyp) is an infrequent, usually solitary, benign, slowly growing lesion that arises from the maxillary antrum and reaches the choana. The initial impression was of a swollen uvula from angioedema secondary to ACE inhibitor use.1 Repeat examination revealed a large antrochoanal polyp to be the cause of his symptoms. Killian's Polyps happen more commonly in children and young adults. Fig. Frosini P et al: Antrochoanal polyp: analysis of 200 cases. Papilloma - they are irregular and friable in appearance and bleed easily; Meningoencephalocele (see meningocele, encephalocele) . The differential diagnosis for ACPs is wide and includes juvenile angiofibroma, herniating mucocele, meningoencephalocele, teratoma, sphenochoanal polyps, and nasopharyngeal malignancies, among others [ 2, 7 ]. . Differential Diagnosis: Antrochoanal polyp, inverting papilloma, minor salivary gland neoplasm, chronic sinus disease. 90% solitary. Differential diagnoses of maxillary masses found in imaging include5 6 7. mucus retention cysts (most frequent) adenoid hypertrophy. Because it's much less liable to cause complications. 1 On CT images, . - anatomopathological examination: will confirm the diagnosis. Am J The polyp is directly in the center and is pale, glistening, and white. Eur Radiol 2000;10:849-51. The most common type is the antrochoanal polyp, which originates in the mucosa of the maxillary sinus or antrum. The antrochoanal polyp. The septum is on the far left. 37 Full PDFs related to this paper. Frequently occur in childhood. The differential diagnosis mainly includes other inflammatory nasal . These polyps are usually presented unilaterally, although bilateral presentation is also possible.
Introduction: Angiomatous antrochoanal nasal polyp (AAP) is a rare and distinct variation of a sinonasal polyp that can be mistaken for a sinonasal malignancy, juvenile nasopharyngeal angiofibroma, or a simple antrochoanal polyp due to its ability to erode bone and cause epistaxis. 29(1):21 -6, 2009. Polyp: Uncommon. The differential diagnosis of ACP should include other pediatric masses. Towbin RDJ, Bove K. Antrochoanal polyps. It passes through the ostium of the sinus into the choana, and from there into the posterior nasopharynx. Otolaryngol Head Neck Surg 2012;146(4):574-578. Antrochoanal polyps are benign, large, inflammatory polyps which originate from within the maxillary sinus and extend through the natural or accessory ostia, into the nasal cavity, with extension into the choana. The differential diagnosis of a choanal polyp includes inverted papilloma; these may look identical on unenhanced sinus CT, with characteristic calcification reported in 10% of inverted papillomas (Figure 10). Inverted . . Eur Radiol 2000;10(5):849-851. . Finally, the various modes of treatment are discussed, focussing in . It warrants special consideration in children because its clinical manifestations may be mimicked by other less benign conditions, such as juvenile angiofibroma, meningoencephalocele, and nasopharyngeal malignancies. . Ethmoidal polyps arise from the ethmoid sinuses and extend through the middle meatus into the nasal cavity. Occasionally, antrochoanal polyps may have a higher density (and Hounsfield values) if they are long-standing (i.e. The lateral nasal wall is on the far right. European radiology. Differential Diagnosis. 1 Sphenochoanal polyps are of uncertain etiology. Objective.
Surgery is the only feasible treatment for antrochoanal polyp. Salib RJ, Sadek SA, Dutt SN, Pearman K. Antrochoanal polyp presenting with obstructive sleep apnoea and cachexia. Other possible 7 The maxillary masses that occur most frequently in children are mucoceles and mucopyoceles, which usually show a characteristic enhanced ring when intravenous contrast is administered. The lateral nasal wall is on the far right. The different varieties of choanal polyps are reviewed by the authors according to their implantation pedicle. Differential diagnosis also includes congenital defects (such as neural tube defects, dermoid cyst, meningocele, and meningoencephalocele), lymphatic tissue hypertrophy, benign tumors (nasal glioma, neurofibroma, craniopharyngioma, and juvenile nasopharyngeal angiofibroma), and malignancies (rhabdomyosarcoma, lymphoma, and nasopharyngeal carcinoma). diagnose. The patient first received a medical preparation with steroids and antibiotics before endoscopic surgery. Antrochoanal polyps usually arise in the maxillary sinus and extend into the nasopharynx and represent only 4-6% of all nasal polyps. There is a high incidence of benign non-neoplastic lesions in our study, constituting about 77.6% of cases while 2.6% were malignant and 19.7% had no pathologic diagnosis. Itgrows byextension from theantrum through . Possible reasons for migration of antrochoanal polyp in to the post nasal space: 1. Why? AMA Arch Otolaryngol 52:538-48. This Paper. Int J Pediatr American Journal of Roentgenology. The septum is on the far left. The prominent dilated vessels of the antrochoanal polyp can also be a helpful distinguishing feature. Because the infection is diagnosis is discussed. Endoscopic view of the left middle meatus. A contrast-enhanced scan is not necessary but may demonstrate peripheral enhancement. 14 An antrochoanal polyp arises from the maxillary sinus and protrudes through the sinus ostium into the nasal cavity. 3. diagnosis is made on the basis of clinical, CT and pathological data. 4. Differential Diagnosis. Nasal polyps, antrochoanal polyps, inverted papilloma, unilateral chronic odontogenic sinusitis with secondary polyps due to chronic infection, unilateral fungal sinusitis, mucoceles, malignancy and cystic fibrosis (similar appearance but commonly bilateral). CT-scan demonstrates the presence of bone destruction. Vera J. Antrochoanal polyps in children: CT findings and differential diagnosis. Choanal polyps are unilateral. The antrochoanal polyp, a benign solitary polypoid lesion, usually arises in a maxillary sinus, opacifying and enlarging the sinus cavity without bone destruction. sinonasal tumours (eg, olfactory neuroblastoma, inverted papilloma, haemangioma, malignancies). The differential diagnosis of nasal polyps can be extensive. This report is based on three cases of antrochoanal polyp, occurring in the pediatric group, and the objective is to demonstrate their different CT characteristics, principal differential diagnoses, and . The soft tissue mass does not Misinterpretation of the REAH as chronic sinus inflammation may result in inadequate treatment. Differential Diagnosis Thediagnosis ofantrochoanal polyp isstrongly sug-gested whenanopacified maxillary antrum isexpanded andthere isanasopharyngeal mass. The antrochoanal polyp or Killian polyp is an infrequent, benign lesion of maxillary origin (90%); it can also develop from the sphenoidal sinus, the ethmoid sinus, the septum, the palate or the frontal sinus. The differential diagnosis is between ACP and tumours such as angiofi broma, olfactory neuroblastoma, meningo-encefalocele or hemangioma. We described two cases of atypically giant antrochoanal polyps: in a 15-year-old child and in a 38-year-old man. An oral examination revealed the . Angiomatous antrochoanal polyps (AAP) are one of the causes but it is rare and the diagnosis is challenging as it mimic other nasal mass especially nasopharyngeal angiofibroma (NA). It accounts for about 5% of all nasal polyps. The antrochoanal polyp, a benign solitary polypoid lesion, usually arises in a maxillary sinus, opacifying and enlarging the sinus cavity without bone destruction.