Nasal polyp
Nasal polypBy d.g
There are two types of nasal polypAntrochoanalEthmoidal
Antrochoanal typeIt arises from the maxillary antrum and grows backwards in to nose towards the choana and nasal cavity riches the nasopharynx .
Ethmoidal They are multiple bilateral and arises from numerous ethmoidal sinuses.It is very commonly found
Etiology ANTROCHOANAL POLYP-Exact cause is not known.AGE: usually it occurs in children and young adults.NUMBER: usually it is single.INFECTION and ALLERGY may result in ANTROCHOANAl POLYP.
ETHMOIDAL POLYPAGE; ethmoidal polyps occurs at any age SEX: both sexes are equally affected PREDISPOSING FACTOTRS:Allergy Vasomotor Infection Mixed infection
Polysaccharide changes Bernouillis phenomenon: when air passes through a narrow area in the nose negativre pressure develops in the viscinity in the paranasal sinuses leading to increased formation of tissue fluids this may encourage polyp formation.
Asthma can be associated with ethmoidal polyp.Aspirin sensitivity
Pathology Antrochoanal polypMacroscopic :antral part : arise from maxillary antrum.Mucosa:oedamatousNasal part: arise from hiatus semilunaris in nose and reaches the choana
Pharyngeal part :enters the naso pharynx through choana.ETHMOIDAL POLYP:Arised from mucosa ethmoidal sinuses and hang down in the nasal cavity .
antrochoanal polyp showing choanal (c)nasal (n) antral (a) parts
ACN
Microscopic Mucous membrane: metaplastiv changes.Polyp: ulcerated or protrudedSubmucoasal tissue:oedamtoius.Cellular infiltration occursPolyp is avascular and pain lessBlood vessels and nerves supply scanty
DIAGRAM OF NASAL POLYPI
Clinical featuresBlocking of noseSneezingDischarger clearExpansion of noseAnosmiaSnoring and mouth breathingheadache
EpiphoraPostnasal dischargeSpeech:hyponasal
Signs External nose: Frog like appearance BROAD NOSEAnterior rhinos copy:antrochonal :rarely visibleEthmoidal:multiple like n bunch of grapesPosterior rhinoscoptyAntrochoanal :large visible like pear shaped Ethmoidal :fairly visible and grow slowly
Investigation Nasal secretion : culture and sensitivity testRadiography test of nose and sinuses.Ct scan of nose and par nasal sinuses.Biopsy of polyp
DIFFERENTIAL DIAGNOSISHypertrophic turbinate'sRhinospordiosisMalignancyAngiomaAdenodsNasopharangeal angiofibromaNasophrangeal malignancyGliomamenegiocle
Treatment antrochoanal polyp: conservativenasal decongestantanrttibioticssurgical:polypectomysinoscopycold weell luc-operation
ETHOMOIDAL POLYPconservative:antihistaminesteroidsantibiotics xecongesatantsurgical:polypectomyethmoidectomysinoscopy
HOMOEOPATHIC TREATMENTcalc.carbkreosotumphosphorushamamelis
DNSdeviated nasal septum:defination:deviation of the septum occurs very frquentlybut it requires treatment only if it produces symptoms
ETIOLOGY AGE:pubertyupto 20 yrssex :both sexeshereditoyrydevelopmental causehigh arched palatecongenital
traumasecondary :tumormasspolyp
PATHOLOGY
deviationspursthickeningdislocationc-shaped or s shaped deviationhypertrophy of turbinates
SYMPTOMS asypmtomatic blocking of nosevacuum headacheneuralgic headcherecurrent cold epistaxis anosmiadeformity
INVESTIGATIONexamination of noseanterior rhinoscopyposterior rhinoscopyradiography of face or nose
COMPLICATIONrecurrent sinusitismiddle ear infectionmouth breathingasthmaatrophic rhinitis
DIFFERENTIAL DIAGNOSIShypertrophic turbinatespolypseptal haematoma
HAEMATOMA
TREATMENTSMR(submucosal resection of nasal septum)septoplasty
HOMOEOPATHIC TREATMENTars.albaconitethuja