Antrochoanal polyps are a rare clinical entity. In this review of patients treated between January 1996 and September 2002, there were 18 cases of antrochoanal polyps. The mean age of patients was 20 years. Nasal obstruction was the most common symptom (17 cases, 94%), followed by rhinorrhoea (44%), epistaxis (33%), postnasal drip (28%), and snoring (22%). Chronic sinus was the most common associated rhinological finding (50%). Various surgical approaches were used: endoscopic polypectomy and middle meatal antrostomy in seven patients (38.9%), endoscopic polypectomy and inferior meatal antrostomy in three patients (16.7%) and Caldwell-Luc surgery in one patient (5.6%). No complications were noted in patients treated with powered instrumentation, including the three patients in whom combined transcanine approaches were used. We concluded that powered endoscopic polypectomy was safe and effective. It allowed a more complete dissection and may diminish the chance of recurrence.
Rhinosporidiosis is a chronic granulomatous disease of the mucous membrane, predominantly of the nose and nasopharynx. It is uncommon in Malaysia but has been seen in immigrant workers from endemic areas like India and Sri Lanka. A case seen in Johor is reported here to highlight the need of awareness among clinicians at a time where there is increasing numbers of immigrant workers in our country. The causative organism of this disease is Rhinosporidium seeberi, which is found in stagnant waters. Sporangia and endospores of R. seeberi are seen in the granulomatous polypoidal lesions. The patients commonly present with epistaxis and nasal blockage. Complete excision is the treatment of choice for this disease. Recurrences are common despite anti-microbial treatment.
We describe a child who presented with intermittent respiratory obstruction especially in supine position. Examination revealed a fleshy post nasal mass extending up to the oropharynx. The mass was removed surgically and histopathology revealed an antrochonal polyp. Patient was relieved of his symptoms and has been well ever since.
The incidence of mucocoeles associated with a non-surgically treated nasal polyposis is rare. We report a rare case of nasal polyposis with asymptomatic frontal mucocoeles in a 28-year-old Malay man who presented with bilateral nasal obstruction with anosmia. Physical examination revealed bilateral grade III nasal polyps causing obstruction. Computed tomography revealed paranasal polyposis with a large polyp extending and expanding the posterior table of the frontal sinus causing erosion and thinning of its wall. Marsupialisation of the mucocoele and nasal polypectomy were done. Endoscopic sinus surgery and marsupialisation should be the treatment of choice for asymptomatic frontal mucocoele.
Background Eosinophilic chronic rhinosinusitis (eCRS) is linked with skewed T-helper 2 or immunoglobulin E (IgE)-mediated allergic responses, with differing diagnosis, prognosis, and management to non-eCRS. Objective The association between biomarkers and eCRS was investigated to assess the predictors of eCRS. Methods A cross-sectional study of adult patients with chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery was conducted. eCRS was defined by histopathological assessment showing >10 eosinophils/high-power field on sinus mucosal biopsy. Blood tests were performed preoperatively and assessed for a full blood count including eosinophils and a white cell count (WCC) as well as biochemical markers of inflammation and atopy including Immunoglobulin E (IgE), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and ImmunoCAP testing for serum-specific IgE. Comparisons between eCRS and non-eCRS patients were performed. Results 345 patients (48.1% female, age 48.72 ± 15.06 years) were recruited, with 206 (59.7%) identified as eCRS, 41% with asthma and 47% CRS with nasal polyps. eCRS patients were more likely to have asthma ( P nasal polyps ( P 0.24 × 109/L), eosinophil ratio (>4.27% of total WCC), and lower ESR when compared with non-eCRS.