Bilateral antrochoanal polyp: case report

Abstract

CRS, a 48 years old male patient, presented with appro-ximately 30 years of bilateral nasal obstruction that was worse on the left, in addition to rhinorrhea, hyposmia, and difficulty sleeping. He denied cacosmia, headaches, and atopic or otological complaints. He also denied smoking or alcohol consumption, allergy to non-steroi-dal anti-inflammatory drugs, asthma, and other comor-bidities. Nasofibroscopic assessment disclosed a polypoid mass completely occluding the nasal cavity bilaterally. Computed tomography (CT) scan of the sinuses disclosed soft-tissue masses in both nasal cavities, larger on the left side, that extended to the choanae (Fig. 1A); bilateral enlargement of the ostiomeatal complex; partial opacification of the cells of the maxillary, ethmoid, and frontal sinuses; and left sphenoid mucosal thickening.Surgery was performed exclusively by nasal endoscopy. The intraoperative findings were limited to a single large polypoid mass in each nostril, arising from the medial wall of the maxillary sinus and extending to each choana; a right middle concha bullosa; edema, and retained secretions in the anterior and posterior ethmoid cells. Pathological assessment showed a 5.0 × 2.0 × 1.0 cm polypoid lesion on the right and a 5.0 × 2.5 × 1.0 cm on the left, covered by respiratory epithelium without goblet cell hyperplasia or basal membrane thickening, with grade 3 edema and grade 1 fibrosis of the stroma, discrete mixed infiltrate with a neutrophile count of four per field and four to six eosinophils per field, with no signs of malignan-cy, consistent with the diagnostic impression of antrocho-anal polyps (Fig. 1B). The patient experienced a complete recovery with resolution of complaints and no recurrence four months postoperatively.