Sinonasal polyposis

Case contributed by Dr Bruno Di Muzio

Presentation

Chronic nasal obstruction.

Patient Data

Age: 32-year-old
Gender: Male
CT

CT Paransal sinuses

Technique: Volumetric axial acquisition through the paranasal sinuses, without contrast administration. 

Findings: Right sinuses and drainage pathways 

Frontal sinus and frontal recess: Normal.

Maxillary sinus: Almost all obliterated by a material with soft tissue attenuation and round superior contours. 

Ethmoid sinuses: Normal.

Ostiomeatal complex: Normal.

Sphenoid sinus: Minimal mucosal thickening with some lobulated nodular components.

Left sinuses and drainage pathways

Frontal sinus and frontal recess: Normal.

Maxillary sinus: Minimal mucosal thickening on the floor.  

Ethmoid sinuses: Normal.

Ostiomeatal complex: Normal.

Sphenoid sinus: Normal.

Other findings

Nasal cavity: polyps obliterating partially the posterior aspect of the right nasal cavity and protruding into the nasopharynx. A right bone spur is noted in the nasal septum. Left middle concha bullosa.

Orbits: Normal.

Conclusion: The above-mentioned findings are n keeping with right sinonasal polyposis. 

Case Discussion

Sinonasal polyposis is usually characterised on CT as soft tissue density polypoid masses within the nasal cavity and paranasal sinuses. As they are not so prominent in this case, it is easy to identify and spot them. In severe cases, in general, the sinuses are completely obliterated and remodeling of sinonasal bones is common. This diagnosis was based on imaging aspects only. 

The only differential diagnosis to be considered is: sinonasal retention cysts , which usually spare the nasal cavity and are commonly asymptomatic. 

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Case information

rID: 41241
Case created: 22nd Nov 2015
Last edited: 22nd Nov 2015
System: Head & Neck
Inclusion in quiz mode: Included

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