eMedicine Specialties > Pediatrics: Surgery > Otolaryngology
Nasal Polyps: Multimedia
Updated: Oct 22, 2008
Multimedia
 | Media file 1: Rigid endoscopic view of the left nasal cavity, showing the septum on the left. Polyps with some blood and hemorrhage are on top of them in the center portion. The rim of white from 1 o'clock to 4 o'clock indicates the lateral nasal wall vestibule. The polyps cover the inferior turbinate, which is partially visible at 4 and 5 o'clock. |
 | Media file 2: Endoscopic view of the left nasal cavity, showing a polyp protruding from the uncinate process. The middle turbinate is to the left. A suction is visible on top of the inferior portion of the uncinate process and inferior portion of the polyp. The lateral nasal wall is on the far right. The polyp is directly in the center and is pale, glistening, and white. |
 | Media file 3: Endoscopic view of the left middle meatus. The septum is on the far left. The middle turbinate is next to the septum on the left. A large, glistening, translucent polyp is visible in the center of the screen next to the middle turbinate. The lateral nasal wall is on the right side of the screen. The inferior turbinate nub posteriorly is in the bottom right hand corner. |
 | Media file 4: Rigid endoscopic view of the left nasal cavity, showing the septum on the left, inferior turbinate on the right, middle turbinate superiorly, and antral-choanal polyp among the floor of the nose. |
 | Media file 5: Rigid endoscopic view of the left anterior nasal cavity, showing the septum on the left, a suction pushing the inferior turbinate on the right, and the clear antral-choanal polyp at the center of the endoscopic view. |
 | Media file 6: Close-up of the middle meatus, showing the stalk of the antral-choanal polyp emanating from the maxillary sinus behind the uncinate process on the bottom right-hand side of the picture. The left side of the picture shows the septum and the middle turbinate being pushed over via suction. |
 | Media file 7: Axial CT scan section through the maxillary sinuses showing opacification of the left maxillary sinus with antral-choanal polyp in the posterior nasal cavity and choana exiting from beneath the middle turbinate in the area of the ostiomeatal complex unit. Scale is in centimeters. |
 | Media file 8: Coronal CT scan through the anterior sinuses showing opacification of the left maxillary sinus with opacification of the inferior half of the nasal cavity on the left, filled by the antral-choanal polyp. The rest of the sinuses are clear. |
 | Media file 9: Coronal CT scan section through the posterior nasopharynx showing the sphenoid sinus superiorly and the antral-choanal polyp filling the nasopharynx in the center of the scan. |
 | Media file 10: Oral cavity and oropharyngeal view of antral-choanal polyp filling the posterior oral pharynx and pushing the soft palate anterior and inferiorly. The polyp is visible behind the uvula and the soft palate. |
 | Media file 11: Scale is in inches. The left side of the lesion was the portion of the polyp in the nasal cavity. The right was a stalk attached to the medial maxillary wall. |
 | Media file 12: Endoscopic view of the left middle meatus, showing the septum on the left, the middle turbinate in the center superiorly, and a large maxillary antrostomy with a curved suction on the right. This is following antral-choanal polyp removal. |
 | Media file 13: An anterior endoscopic view of the nasal cavity in a 5-month-old infant. The vestibule is seen in the periphery of the picture. In the center of the picture, the septum is visible to the left, and the inferior turbinate is to the right. These structures are reddish in hue. Some congestion in the nasal cavity is usually present. These are often structures that can be seen only by anterior rhinoscopy. If the area is decongested, the area of the middle meatus can occasionally be seen. |
 | Media file 14: A rigid rhinoscopy photograph of the left anterior nasal cavity. The middle turbinate is superiorly in the midline, and the inferior turbinate is to the right. The septum is to the left. This photograph is the first of 4 images of the rigid rhinoscopy pathway down the nasal cavity of a 6-week-old infant. |
 | Media file 15: A 3-month-old infant with hypertelorism and bulging of the nasal dorsum, secondary to encephalocele. |
 | Media file 16: Interior view of the nose and nasal cavities. To the right of the patient's left nostril, the right nasal cavity has no obstruction. On the left of the picture, a reddish polyp is visible. The reddish mass is a nasal glioma. |
 | Media file 17: A close-up view of the right nasal cavity and polyp #5 in a 5-month-old infant. The obstructing reddish polyp is visible. This is an intranasal glioma that was arising from the attachment of the inferior turbinate anteriorly; it was transnasally removed. |
 | Media file 18: Anterior nasal papilloma arising from the septum. The skin of the nasal vestibule is seen surrounding the papilloma in the center of the image. |
 | Media file 19: Axial MRI scan of the orbits, posterior fossa, and nasal cavity. The solid tumor is seen filling the posterior ethmoid complex, brain stem, cavernous sinuses, and left anterior cranial fossa. |
 | Media file 20: Axial CT scan through the orbits and ethmoid sinuses, showing the rhabdomyosarcoma in the same areas, including the posterior ethmoid complex, left middle fossa, and skull base of cavernous sinuses. |
 | Media file 21: Rigid endoscopic view of left nasal cavity, showing a polyp in the center of the picture, with extension of the rhabdomyosarcoma. The septum is on the left and the middle turbinate is on the right. |
 | Media file 22: Endoscopic view of the left nasal cavity posteriorly, showing a polyp emanating from the sphenoid sinus in the center of the picture and purulence above and below the polyp. On the left is the septum. On the right is the lateral aspect of the middle turbinate. |
 | Media file 23: Frontal view of a 2-day-old infant with swelling in the inferior medial canthal area on both sides. The right side appears more prominent on this picture. CT scan showed infected nasal lacrimal duct cysts. |
 | Media file 24: Rigid endoscopic view of the left nasal cavity. The septum is on the left, and the lateral nasal wall is on the right. The inferior turbinate is in the center of the picture, and the middle turbinates are visible in the superior midsection of the picture. The nasal lacrimal duct cyst is the yellow dilated lesion underneath the inferior turbinate. |
 | Media file 25: Axial CT scan section through the orbit, showing the dilated nasal lacrimal ducts in the medial anterior area compared to the orbits. Scale on the bottom right is in centimeters. |
 | Media file 26: Axial CT scan through the inferior nasal cavities, showing the dilated nasal lacrimal duct cysts at the inferior location. Scale on the bottom right is in centimeters. The dilated cysts are in the center of the image. |
 | Media file 27: A frontal view of the decompressed nasal lacrimal ducts following surgical marsupialization. The swelling in the inferior medial canthal areas, portrayed in Media file 23, is no longer seen. |
 | Media file 28: Lateral view of a preteenaged child showing infected nasal dermoid. Note the protrusion of the dorsum of the nose. This is the same child as in Image 29. |
 | Media file 29: Preteenaged boy with infected nasal dermoid. A pith is visible over the superior portion of the swelling between the eyes. Nasal pith is commonly seen with the nasal dermoid. |
 | Media file 30: Frontal view of a 5-month-old infant, showing hypertelorism and protrusion in the glabellar region secondary to a small nasal dermoid. |
 | Media file 31: Axial CT scan (bony windows) showing a 5-month-old infant with nasal dermoid anterior to the nasal and maxillary bones. No bony dehiscence or bony abnormalities are visible. |
 | Media file 32: A coronal MRI scan through the nasal dermoid. The scale on the left is 2 mm per small bar and 1 cm per tall bar. The arrow points to the lesion. The lesion appears to be approximately 6-7 mm in this dimension. This is the same patient as in Media files 30-31 and Media file 33. |
 | Media file 33: An interoperative view of dermoid removal. This is the same patient as in Media files 30-32. |
 | Media file 34: A surgical microdebrider entering the middle meatus. The septum is on the far left. The middle turbinate is in the left center. The surgical microdebrider is on the inferior center. Inferior turbinate is seen on the bottom right. Some blood overlying the ethmoid cavity is noted where polyps were present in the center of the picture. |
 | Media file 35: Coronal section through the ethmoid maxillary sinuses and orbits. This is a 2-year-old child with cystic fibrosis, showing complete opacification of the maxillary and ethmoid sinuses. Bulging in the medial maxillary walls is observed. |
 | Media file 36: Coronal section of the same patient as in Media file 35, showing soft tissue windows rather than bony windows. It indicates the infection by the thick mucus in the maxillary and ethmoid cavities by the heterogeneity of the opacification in the sinuses. Note that the nasal cavity is completely obliterated by polyp disease. |
 | Media file 37: A rigid rhinoscopy photograph taken all the way back into the choanae of the left nasal cavity. The photograph shows the septum on the left, the small adenoids on the posterior superior wall of the nasopharynx in the center, and the eustachian tube orifice on the right. This photograph is the fourth of 4 images of the rigid rhinoscopy pathway down the nasal cavity of a 6-week-old infant. |
 | Media file 38: A rigid rhinoscopy photograph taken in the midportion of the left nasal cavity showing the septum on the left, the inferior turbinate on the right, and the middle turbinate superiorly. The choanae is seen in the dark area in the center. This photograph is the second of 4 images of the rigid rhinoscopy pathway down the nasal cavity of a 6-week-old infant. The first one is Media file 14. |
 | Media file 39: A rigid rhinoscopy photograph taken two thirds of the way back along the floor of the nose of the left nasal cavity. This photograph shows the septum on the left, the choanae straight ahead, and the posterior portion inferior turbinate to the right. This photograph is the third of 4 images of the rigid rhinoscopy pathway down the nasal cavity of a 6-week-old infant. |
 | Media file 40: A coronal CT scan section through the orbit to maxillary sinus. The medial maxillary walls bulge medially, which is a typical CT scan view of cystic fibrosis. The ethmoid sinuses have scattered disease. |
 | Media file 41: View just inside the nasal vestibule of the patient seen in Media file 45, showing diffused polyposis extending into the anterior nasal cavity and vestibule; the septum is on the right, and the right lateral vestibular wall (nasal ala) is on the left. The polyps are all in the center. The polyps almost hang out of the nasal vestibule. |
 | Media file 42: Coronal CT scan of the same patient as in Media file 45, showing extensive allergic fungal sinusitis involving the right side with mucocele above the right orbit and expansion of the sinuses on the right. |
 | Media file 43: Coronal CT scan of the same patient as in Media file 46 showing typical unilateral appearance of allergic sinusitis with hyperintense areas and inhomogeneity of the sinus opacification; the hyperintense areas appear whitish in the center of the allergic mucin. |
 | Media file 44: Coronal MRI scan of the same patient as in Media file 45, showing expansion of the sinuses with allergic mucin and polypoid disease; the hypointense black areas in the nasal cavities are the actual fungal elements and debris. The density above the right eye is the mucocele. The fungal elements and allergic mucin in allergic fungal sinusitis always look hypointense on MRI scanning and can be mistaken for absence of disease. |
 | Media file 45: Fifteen year-old adolescent boy with allergic fungal sinusitis causing right proptosis, telecanthus, and malar flattening; position of his eyes is asymmetrical, and his nasal ala on the right is pushed inferiorly compared with the left. |
 | Media file 46: Nine-year-old girl with allergic fungal sinusitis displaying telecanthus and asymmetrical positioning of her eyes and globes. |
More on Nasal Polyps |
| Overview: Nasal Polyps |
| Differential Diagnoses & Workup: Nasal Polyps |
| Treatment & Medication: Nasal Polyps |
| Follow-up: Nasal Polyps |
 Multimedia: Nasal Polyps |
| References |
| « Previous Page |
References
Bernstein JM, Gorfien J, Noble B. Role of allergy in nasal polyposis: a review. Otolaryngol Head Neck Surg. Dec 1995;113(6):724-32. [Medline].
Tos M, Sasaki Y, Ohnishi M, Larsen P, Drake-Lee AB. Fireside conference 2. Pathogenesis of nasal polyps. Rhinol Suppl. 1992;14:181-5. [Medline].
Stammberger H. Surgical treatment of nasal polyps: past, present, and future. Allergy. 1999;54 Suppl 53:7-11. [Medline].
Mabry RL, Marple BF, Folker RJ, Mabry CS. Immunotherapy for allergic fungal sinusitis: three years' experience. Otolaryngol Head Neck Surg. Dec 1998;119(6):648-51. [Medline].
Holmstrom M. Clinical performance of fluticasone propionate nasal drops. Allergy. 1999;54 Suppl 53:21-5. [Medline].
Lund VJ, Flood J, Sykes AP, Richards DH. Effect of fluticasone in severe polyposis. Arch Otolaryngol Head Neck Surg. May 1998;124(5):513-8. [Medline].
Andrews AE, Bryson JM, Rowe-Jones JM. Site of origin of nasal polyps: relevance to pathogenesis and management. Rhinology. Sep 2005;43(3):180-4. [Medline].
Babinski D, Trawinska-Bartnicka M. Rhinosinusitis in cystic fibrosis: not a simple story. Int J Pediatr Otorhinolaryngol. May 2008;72(5):619-24. [Medline].
Bachert C, Watelet JB, Gevaert P, Van Cauwenberge P. Pharmacological management of nasal polyposis. Drugs. 2005;65(11):1537-52. [Medline].
Bateman ND, Shahi A, Feeley KM, Woolford TJ. Activated eosinophils in nasal polyps: a comparison of asthmatic and non-asthmatic patients. Clin Otolaryngol. Jun 2005;30(3):221-5. [Medline].
Bernstein JM. Update on the molecular biology of nasal polyposis. Otolaryngol Clin North Am. Dec 2005;38(6):1243-55. [Medline].
Blaiss MS. Expanding the evidence base for the medical treatment of nasal polyposis. J Allergy Clin Immunol. Dec 2005;116(6):1272-4. [Medline].
Bugten V, Nordgard S, Steinsvag S. Long-term effects of postoperative measures after sinus surgery. Eur Arch Otorhinolaryngol. May 2008;265(5):531-7. [Medline].
Dunlop G, Scadding GK, Lund VJ. The effect of endoscopic sinus surgery on asthma: management of patients with chronic rhinosinusitis, nasal polyposis, and asthma. Am J Rhinol. Jul-Aug 1999;13(4):261-5. [Medline].
Eghtedari F, Cheraghzadeh SR, Kashef MA, Monabati A, Kashef S. Agreement rate of skin prick test with tissue eosinophil count in patients with nasal polyps. Iran J Allergy Asthma Immunol. Jun 2007;6(2):89-92. [Medline].
Eliashar R, Levi-Schaffer F. The role of the eosinophil in nasal diseases. Curr Opin Otolaryngol Head Neck Surg. Jun 2005;13(3):171-5. [Medline].
European position paper on rhinosinusitis and nasal polyps. Rhinol Suppl. 2005;1-87. [Medline].
Hedman J, Kaprio J, Poussa T, Nieminen MM. Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol. Aug 1999;28(4):717-22. [Medline].
Kieff DA, Busaba NY. Efficacy of montelukast in the treatment of nasal polyposis. Ann Otol Rhinol Laryngol. Dec 2005;114(12):941-5. [Medline].
Kramer MF, Rasp G. Nasal polyposis: eosinophils and interleukin-5. Allergy. Jul 1999;54(7):669-80. [Medline].
Lee CH, Lee KS, Rhee CS, Lee SO, Min YG. Distribution of rantes and interleukin-5 in allergic nasal mucosa and nasal polyps. Ann Otol Rhinol Laryngol. Jun 1999;108(6):594-8. [Medline].
Lund V. Advances in the treatment of nasal polypopsis. Introduction. Allergy. 1999;54 Suppl 53:5-6. [Medline].
Lund VJ. The effect of sinonasal surgery on asthma. Allergy. 1999;54 Suppl 57:141-5. [Medline].
Morinaka S, Nakamura H. Inflammatory cells in nasal mucosa and nasal polyps. Auris Nasus Larynx. Jan 2000;27(1):59-64. [Medline].
Mygind N. Advances in the medical treatment of nasal polyps. Allergy. 1999;54 Suppl 53:12-6. [Medline].
Mygind N, Dahl R, Bachert C. Nasal polyposis, eosinophil dominated inflammation, and allergy. Thorax. Oct 2000;55 Suppl 2:S79-83. [Medline].
Nakamura H, Kawasaki M, Higuchi Y, Takahashi S. Effects of sinus surgery on asthma in aspirin triad patients. Acta Otolaryngol. 1999;119(5):592-8. [Medline].
Norlander T, Bronnegard M, Stierna P. The relationship of nasal polyps, infection, and inflammation. Am J Rhinol. Sep-Oct 1999;13(5):349-55. [Medline].
Pawliczak R, Lewandowska-Polak A, Kowalski ML. Pathogenesis of nasal polyps: an update. Curr Allergy Asthma Rep. Nov 2005;5(6):463-71. [Medline].
Radenne F, Lamblin C, Vandezande LM, et al. Quality of life in nasal polyposis. J Allergy Clin Immunol. Jul 1999;104(1):79-84. [Medline].
Rudack C, Bachert C, Stoll W. Effect of prednisolone on cytokine synthesis in nasal polyps. J Interferon Cytokine Res. Sep 1999;19(9):1031-5. [Medline].
Slavin SA. The rectus abdominis myocutaneous flap: observation and refinements. Plast Reconstr Surg. Feb 1983;71(2):280-1. [Medline].
Small CB, Hernandez J, Reyes A, et al. Efficacy and safety of mometasone furoate nasal spray in nasal polyposis. J Allergy Clin Immunol. Dec 2005;116(6):1275-81. [Medline].
Uneri C, Ozturk O, Polat S, Yuksel M, Haklar G. Determination of reactive oxygen species in nasal polyps. Rhinology. Sep 2005;43(3):185-9. [Medline].
Young MC. Rhinitis, sinusitis, and polyposis. Allergy Asthma Proc. Jul-Aug 1998;19(4):211-8. [Medline].
Further Reading
Keywords
nasal polyps, nasal polyposis, nasal mucosa, paranasal sinuses, nasal lesion, chronic sinusitis, allergic rhinitis, cystic fibrosis, CF, allergic fungal sinusitis, AFS, antral-choanal polyp, encephaloceles, gliomas
hemangiomas, papillomas, juvenile nasopharyngeal angiofibromas, rhabdomyosarcoma, lymphoma, neuroblastoma, sarcoma, chordoma, nasopharyngeal carcinoma, inverting papilloma, multiple nasal polyposis, asthma
chronic rhinosinusitis, primary ciliary dyskinesia, Churg-Strauss syndrome, Young syndrome, nonallergic rhinitis with eosinophilia syndrome, NARES, nasal obstruction, anosmia, snoring, postnasal drainage, rhinorrhea, hyposmia, proptosis, hypertelorism, diplopia, nasolacrimal duct cyst
