Kronik Rinosinüzit Tanılı Bir Hastada Antrokoanal Polip ve Etmoidal Poliplerin Eş Zamanlı Görülmesi: Nadir Bir Klinik Olgu ve Literatürün Gözden Geçirilmesi

Öz

Otuz sekiz yaşında erkek hasta, sol taraflı ilerleyici burun tıkanıklığı ve bilateral burun akıntısı (sağ taraf sol taraftan daha fazla), sol tarafta hiposmi ve ağız solunumu atakları ile başvurdu. Hasta değerlendirildi ve burun ve paranazal sinüslerin bilgisayarlı tomografi taraması, pansinüzitli sol Antrokoanal (AC) polipini düşündürdü. Tanısal nazal endoskopi, bilateral etmoidal polipi ile sol AC polipi gösterdi. Bu bulgularla hasta endoskopik polipektomi ve fonksiyonel endoskopik sinüs cerrahisi (FESS) için gönderildi. Histopatoloji raporu sol taraflı AC polipi ve bilateral etmoidal polipiyi doğruladı. Literatürde aynı kişide hem AC polipinin hem de etmoidal polipinin eş zamanlı olarak görülmesi çok nadir olduğundan, her iki polip tipinin etiyopatogenezini yeniden ele aldığımız ve eş zamanlı görülmeyle ilgili literatürü gözden geçirdiğimiz bu olguyu sunuyoruz.

Anahtar Kelimeler

• Antrokoanal polip
• etmoidal polip
• polipektomi
• endoskopik sinüs cerrahisi

Antrochoanal Polyp and Ethmoidal Polypi Presenting Simultaneously in a Patient with Chronic Rhinosinusitis: A Rare Clinical Occurrence and Review of Literature

Abstract

A thirty-eight years old male patient presented with recurrent episodes of left sided progressive nasal obstruction & bilateral nasal discharge (Right side more than left side), left sided hyposmia & mouth breathing. Patient was evaluated and Computed tomography scan of nose and paranasal sinuses was suggestive of left Antrochoanal (AC) polyp with pansinusitis. Diagnostic nasal endoscopy showed left AC polyp with bilateral ethmoidal polypi. With these findings patient was posted for endoscopic polypectomy and functional endoscopic sinus surgery (FESS). Histopathology report confirmed left sided AC polyp and bilateral ethmoidal polypi. Since simultaneous occurrence of both AC polyp and ethmoidal polypi in the same individual is very rarely documented in the literature, we are presenting this case through which we are revisiting the etiopathogenesis of both types of Polyps and also review the literature regarding simultaneous occurrence.

Keywords

• Antrochoanal polyp
• ethmoidal polypi
• polypectomy
• endoscopic sinus surgery

References

1. 1. Watkinson J, Clarke R, eds. Scott-Brown's Otorhinolaryngology and Head and Neck Surgery: 3 Volume Set. CRC Press; 2018.
2. 2. Olajuyin OA, Olajide TG. Patterns, presentations and prognosis of nasal polyps. Indian J Otolaryngol Head Neck Surg. 2019;71:1770-1774.
3. 3. Assaduzzaman AK, Rabiul A, Uddin MM, Chowdhury MI, Mannan MA. A comparative study on association of allergy between ethmoidal and antrochoanal polyps. J Armed Forces Med Coll Bangladesh. 2011;44:35-39.
4. 4. Singhal P. Bilateral antrochoanal polyp in an adult: a rarity. Clin Rhinol Int J. 2011;4(3):145-146.
5. 5. Shruthi PV. Clinical profile of cases with sino-nasal polyposis at a tertiary care hospital at North Karnataka: a cross-sectional study. Int J Otorhinolaryngol Head Neck Surg. 2019;5(4):912.
6. 6. Newton JR, Ah-See KW. A review of nasal polyposis. Ther Clin Risk Manag. 2008;4(2):507-512.
7. 7. Frosini P, Picarella G, De Campora E. Antrochoanal polyp: analysis of 200 cases. Acta Otorhinolaryngol Ital. 2009;29(1):21-26.
8. 8. Islas FA, González JL, Camarillo JM. Antrochoanal polyp: a literature update. J Otolaryngol Rhinol. 2018;4:049.

9. 9. Goulioumis AK, Kourelis K, Gkorpa M, Danielides V. Pathogenesis of nasal polyposis: current trends. Indian J Otolaryngol Head Neck Surg. 2023;75(Suppl 1):733-741.
10. 10. Fokkens WJ, Lund VJ, Hopkins C, et al. Executive summary of EPOS 2020 including integrated care pathways. Rhinology. 2020;58(2):82-111.