Adult nasopharyngeal hairy polyp presenting with middle ear effusion

Öz

Adult nasopharyngeal hairy polyp presenting with middle ear effusion

Abstract

Inroduction: Hairy polyp is a relatively uncommon congenital mass mainly seen in naso-oropharynx. It has been also called as choristoma owing to its bigerminal composition and unexpected location.  It is almost always seen at birth and in the early infancy period.  Adult presentation is very exceptional and only 5 adult cases have been reported as far as we know.

Case Presentation: We present a case of nasopharyngeal hairy polyp in a 69 year old woman admitted with hearing impairment due to middle ear effusion. We also review the relevant literature. The lesion was totally removed via combined naso-endoscopic and trans-oral approach. After 1 year of follow up there was no sign of recurrence neither in the endoscopic evaluation nor in the magnetic resonance imaging.

Conclusion: Although nasopharyngeal hairy polyp frequently leads ear problems in the infancy period, the presented case is the 1’st adult hairy polyp case with middle ear effusion. Also it is the 2’nd oldest one so far.

Keywords

• Choristoma
• Eustachian tube
• Nasopharynx
• Hairy polyp
• Adult

References

1. 1. Brown-Kelly A. Hairy or dermoid polyp of the pharynx and nasopharynx. The Journal of Laryngol Otol. 1918;33:65–70.
2. 2. De Caluwe D, Kealey SM, Hayes R, Puri P. Autoamputation of a congenital oropharyngeal hairy polyp. Pediatric surgery international. 2002;18(5- 6):548-9.
3. 3. Dutta M, Roy S, Ghatak S. Naso-oropharyngeal choristoma (hairy polyps): an overview and current update on presentation, management, origin and related controversies. European archives of oto-rhinolaryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies. 2014.
4. 4. Yilmaz M, Ibrahimov M, Ozturk O, Karaman E, Aslan M. Congenital hairy polyp of the soft palate. International journal of pediatric otorhinolaryngology. 2012;76(1):5-8.
5. 5. Saliba I, El Khatib N, Quintal MC, Arcand P. Tonsillar hairy polyp. Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale. 2010;39(5):E67-9.
6. 6. Karabekmez FE, Duymaz A, Keskin M, Tosun Z. Reconstruction of a "double pathology" on a soft palate: hairy polyp and cleft palate. Annals of plastic surgery. 2009;63(4):393-5.
7. 7. Arnold J. A case of congenital composite lipoma of the tongue and pharynx with perforation into the cranial cavity [in German]. Virchows Arch fur Pathol Anat Physiol Klinical Medicine. 1870;50:482–516.
8. 8. Kelly A, Bough ID, Jr., Luft JD, Conard K, Reilly JS, Tuttle D. Hairy polyp of the oropharynx: case report and literature review. Journal of pediatric surgery. 1996;31(5):704-6.

9. 9. Budenz CL, Lesperance MM, Gebarski S. Hairy polyp of the pharynx obscured on physical examination by endotracheal tube, but diagnosed on brain imaging. Pediatric radiology. 2005;35(11):1107-9.
10. 10. Green VS, Pearl GS. A 24-year-old woman with a nasopharyngeal mass. Benign nasopharyngeal hairy polyp. Archives of pathology & laboratory medicine. 2006;130(3):e33-4.
11. 11. Arnold J. Ein Fall von Congenitalem Zusammengesetztem Lipom der Zunge und des Pharynx. Virchows Arch. 1880;50:482.
12. 12. Agrawal N, Kanabar D, Morrison GA. Combined transoral and nasendoscopic resection of an eustachian tube hairy polyp causing neonatal respiratory distress. American journal of otolaryngology. 2009;30(5):343-6.
13. 13. Tariq MU, Din NU, Bashir MR. Hairy polyp, a clinicopathologic study of four cases. Head and neck pathology. 2013;7(3):232-5.