Nasal polyps are fleshy outgrowths of the nasal mucosa that form at the site of dependent edema in the lamina propria of the mucous membrane, usually around the ostia of the maxillary sinuses. In this post we will discuss ethmoidal polyp.
What is ethmoidal polyp ?
Ethmoidal polyps are multiple, bilateral, painless lumps that resemble grapes and are made up of pearly white tissue. Multiple air cells called ethmoidal air cells are situated medially to the eyes.
Causes of ethmoidal polyp
Allergic rhinitis, acute and chronic infections, and cystic fibrosis all predispose to the formation of ethmoidal polyps. Bleeding polyps occur in rhinosporidiosis. Unilateral polyps occasionally occur in association with or represent benign or malignant tumors of the nose or paranasal sinuses. They can also occur in response to a foreign body. ethmoidal polyps are strongly associated with
Aspirin allergy
Sinus infections
Asthma
Signs and symptoms
- obstruction and postnasal drainage
- congestion
- sneezing
- rhinorrhea
- anosmia
- Â hyposmia
- facial pain, and ocular itching.
Diagnosis
X-rays of the paranasal sinuses are useful for determining the severity of sinus disease.
The preferred investigation is a paranasal sinus CT scan. The posterior ethmoidal air cells, the cribriform plate, the lamina papyracea, and the severity of the disease are all visible on a CT scan.
Treatment of ethmoidal polyp
Topical corticosteroid spray
Sometimes surgical removal
Corticosteroids (eg, mometasone [30 mcg/spray], beclomethasone [42 mcg/spray], flunisolide [25 mcg/spray] aerosols), given as 1 or 2 sprays 2 times a day in each nasal cavity, may shrink or eliminate polyps, as may a 1-week tapered course of oral corticosteroids. In patients with severe chronic rhinosinusitis with ehmoidal polyp, biologics (eg, dupilumab) have been effective by shrinking the polyps and improving symptomsÂ
Surgical removal is required in many cases. Polyps that obstruct the airway or promote sinusitis are removed, as are unilateral polyps that may be obscuring benign or malignant tumors.
Polyps tend to recur unless the underlying allergy or infection is controlled. After removal of ethmoidal polyps, topical beclomethasone or flunisolide therapy tends to retard recurrence. In severe recurrent cases, maxillary sinusotomy or ethmoidectomy may be indicated. These procedures are usually done endoscopically.
Article writer
This article was written by Hashem Khdour, Medical Doctor and the founder of Medicogenic medicine learning & health website
