摘要
Background: Ethmoidal polyposis coexisting with adenoid enlargement and tympanic membrane perforation is a rare condition in otolaryngological practice. Evidences have shown that antrochoanal polyp often times coexists with adenoid enlargement especially in the young which was in sharp contrast to ethmoidal polyposis occurring in the presence of adenoid enlargement. Moreover, the hidden location of nasopharynx housing the adenoids, coupled with the masking effect of bilateral sinonasal polyps, leads to inadvertent misdiagnosis of this complex pathology with subsequent difficulty in providing effective management. Case Presentation: A 24 year-old lady presented with recurrent bilateral nasal obstruction that became persistent associated with nasal discharge and anosmia. She also had recurrent right otorrhoea with associated hearing loss. Diagnostic rigid nasal endoscopy revealed mucoid discharge with bilateral polypoid masses filling both nasal cavities. Otoendoscopic finding revealed a small (about 5%) central tympanic membrane perforation. A clinical assessment of chronic rhinosinusitis with nasal polyposis complicated by chronic suppurative otitis media (CSOM) was made. A non-contrast CT scan of the paranasal sinuses showed isodense lesions in the nasal cavities, all paranasal sinuses and the entire nasopharynx. She had endoscopic sinus surgery and a nasopharyngeal clearance biopsy. The nasal, paranasal and nasopharyngeal masses had histologic confirmation of inflammatory nasal polyps and lymphoid (adenoid) hyperplasia respectively. Her condition improved remarkably with subsequent medical treatment. She was followed up for 8 months and no recurrence was observed. Conclusion: Sinonasal polyposis can coexist with adenoid hypertrophy and middle ear disease as a single pathological condition. Hence, a high index of suspicion and thorough evaluation become necessary for making timely diagnoses and instituting effective management.
Background: Ethmoidal polyposis coexisting with adenoid enlargement and tympanic membrane perforation is a rare condition in otolaryngological practice. Evidences have shown that antrochoanal polyp often times coexists with adenoid enlargement especially in the young which was in sharp contrast to ethmoidal polyposis occurring in the presence of adenoid enlargement. Moreover, the hidden location of nasopharynx housing the adenoids, coupled with the masking effect of bilateral sinonasal polyps, leads to inadvertent misdiagnosis of this complex pathology with subsequent difficulty in providing effective management. Case Presentation: A 24 year-old lady presented with recurrent bilateral nasal obstruction that became persistent associated with nasal discharge and anosmia. She also had recurrent right otorrhoea with associated hearing loss. Diagnostic rigid nasal endoscopy revealed mucoid discharge with bilateral polypoid masses filling both nasal cavities. Otoendoscopic finding revealed a small (about 5%) central tympanic membrane perforation. A clinical assessment of chronic rhinosinusitis with nasal polyposis complicated by chronic suppurative otitis media (CSOM) was made. A non-contrast CT scan of the paranasal sinuses showed isodense lesions in the nasal cavities, all paranasal sinuses and the entire nasopharynx. She had endoscopic sinus surgery and a nasopharyngeal clearance biopsy. The nasal, paranasal and nasopharyngeal masses had histologic confirmation of inflammatory nasal polyps and lymphoid (adenoid) hyperplasia respectively. Her condition improved remarkably with subsequent medical treatment. She was followed up for 8 months and no recurrence was observed. Conclusion: Sinonasal polyposis can coexist with adenoid hypertrophy and middle ear disease as a single pathological condition. Hence, a high index of suspicion and thorough evaluation become necessary for making timely diagnoses and instituting effective management.
作者
Ahmad Mahmud
Mohammed Bello Fufore
Abubakar Umar
Hamisu Abdullahi
Thomas Musa Samdi
Auwal Adamu
Onyekwere George B. Nwaorgu
Ahmad Mahmud;Mohammed Bello Fufore;Abubakar Umar;Hamisu Abdullahi;Thomas Musa Samdi;Auwal Adamu;Onyekwere George B. Nwaorgu(Department of Otorhinolaryngology, Modibbo Adama University/Modibbo Adama University Teaching Hospital, Yola, Nigeria;Department of Otorhinolaryngology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria;National Ear Care Centre (NECC), Kaduna, Nigeria;Department of ENT, Abubakar Tafawa Balewa Teaching Hospital, Bauchi, Nigeria;Department of ENT, Federal University of Health Sciences Azare, Bauchi, Nigeria;Department of Otorhinolaryngology, University College Hospital Ibadan/College of Medicine University of Ibadan, Ibadan, Nigeria)
