Sinonasal polyposis
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Sinonasal polyposis refers to the presence of multiple benign polyps in the nasal cavity and paranasal sinuses. It causes a particular pattern of chronic sinusitis.
Clinical presentation
Clinical symptoms may include 3
- progressive nasal stuffiness
- rhinorrhoea
- facial pain
- headache
- anosmia
Radiographic features
CT
- extensive mucosal polyps occupying and obliterating the nasal cavity and the paranasal sinuses
- usually, they are hypodense, but may be hyperdense due increased protein content or fungal infection
- associated local benign bone remodelling or erosion (as opposed to a mucocoele where the entire sinus is expanded 6)
- enlargement of infundibula
- attenuation of the ethmoid sinus walls and nasal septum
- occasionally sparing of the inferior nasal meatus
- truncation of middle turbinate 4
- opacified ethmoid sinuses with convex lateral walls and air-fluid levels
- a concurrent fungal sinus infection may be present
Differential diagnosis
-
sinonasal retention cyst
- can be indistinguishable
- usually spares the nasal cavity
-
allergic fungal sinusitis
- commonly associated with polyps
- hyperdense central areas
- MRI may show low T1 and T2 signal
-
granulomatosis with polyangiitis
- centred in the nasal cavity
-<a href="/articles/granulomatosis-with-polyangiitis-upper-respiratory-tract-manifestations-2">G</a>ranulomatosis with polyangiitis<ul><li>centred in the nasal cavity</li></ul>- +<a title="Granulomatosis with polyangiitis" href="/articles/granulomatosis-with-polyangiitis">granulomatosis with polyangiitis</a><ul><li>centred in the nasal cavity</li></ul>
-</ul><p> </p>- +</ul>