Taylan Gun1*, Osman Fatih Boztepe2 and Murat Timur Akçam3
1MD, Assistant Professor at Bahçeşehir University, Faculty of Medicine, ENT Department, Ankara Medical Park Hospital, Ankara, Turkey
2MD, Assistant Professor at İstinye University, İstanbul, Turkey
3MD, Ankara Medical Park Hospital, Otolaryngology Department, Ankara, Turkey
Received: 18 September, 2017; Accepted: 23 September, 2017; Published: 25 September, 2017
Dr. Taylan Gun, Ankara Medical Park Hospital Kentkoop mah. 1868 sok. No:15, Batıkent/Ankara, Turkey, Tel: +90 312 6668000, +90 532 3435019; Fax: +90 312 6668666; E-mail:
Gun T, Boztepe OF, Akçam MT (2017) Giant antrochoanal polyp presenting as oropharyngeal mass. Arch Otolaryngol Rhinol 3(3): 103-105. DOI: 10.17352/2455-1759.000058
© 2017 Gun T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Antrochoanal polyp; Endoscopic sinus surgery; Caldwell-Luc operation
Antrochoanal polyps are benign mucosal lesions emerging from the maxillary sinus. The primary symptoms are nasal obstruction and rhinorrhea. Endoscopic and radiological appearance of the disease is typical. These polyps are usually presented unilaterally, although bilateral presentation is also possible. In this paper, we report a case of atypically giant antrochoanal polyp in a 13-year-old child. The patient’s primary complaint was a sensation of lump in her throat. The examination revealed a mass behind soft palate. The excised polyp had the histological characteristic of an angiomatous antrochoanal polyp. Because of the unusual dimension, the combined transoral and endonasal endoscopic approach was performed for complete polyp excision. We discussed the clinical, histopathological and immunohistochemical characteristics of choanal polyps in comparison to inflammatory nasal polyps, and the applicable surgical techniques for treatment of these polyps.
Antrochoanal polyps (ACP) originate from the mucosa of maxillary antrum and enlarge through the ethmoidal infundibulum or an accessory opening in the medial wall of the maxillary sinus into the nasal cavity and gradually prolapse towards nasopharynx. Killian described this disease in detail in 1906 . Stammberger found that antrochoanal polyps left the sinus through an accessory ostium in 70% of the cases . Maxillary antrum is the most common site of origin of choanal polyps. Other sites of origin are the sphenoid, ethmoid, septum, and inferior turbinates [3,4]. These polyps represent 4–6 % of all nasal polyps . Clinically, choanal polyps usually manifest as nasal obstruction, however, epistaxis, rhinophonia, purulant discharge, spontaneous amputation are also reported [4,5]. They are often unilateral but may be bilateral on rare occasions [3,4]. In this paper, we report a case of unusually giant antrochoanal polyp which presents as a large oropharyngeal mass.
A 13 year old girl admitted to our clinic with a history of nasal obstruction, rhinophonia, sensation of foreign body in the throat, snoring and weight loss. The patient had cachectic appearance but defined no other health problems. Physical examination revealed that huge mass hanging from the nasopharynx into the oropharynx and the mass was dislocating the soft palate anteriorly (Figure 1). The mass has smooth surface and could be mobile when touched by a suction. Nasal endoscopy showed that the mass arose from the left maxillary antrum and extending into nasopharynx and oropharynx.
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