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