Monday, February 5, 2018

Pearls on polyps

Hey everyone, this is my first blog! So I realised recently that Ear, Nose, Throat (or ENT for short) has a lot of theory so here's a short post on nasal polyps, for remembering this short, important but a little tedious topic. 

Antrochoanal and ethmoidal polyps are the commonly found types of polypoid growths found in the nasal cavity. They can be fleshy growth of tissue due to various causes, and usually leads to complaints of nasal obstruction and breathing difficulties. Here's a guide to remember the points of difference between the antrochoanal and ethmoidal polyps. For the following:

A - age 

A - aetiology

N - number

L - laterality

O - origin

G - growth

S - size and shape

R - recurrence

T - treatment 

The mnemonic is: "An Apple Never Lives On Green Shrubs (and) Red Trees" 

Interesting imagery, ain't it? 

So what are the differences between the two types of polyps based on these points? 

Age - antrochoanal polyps are found in children, whereas ethmoidal are found in adults. 

Aetiology - usually antrochoanal are having an infectious aetiology, whereas ethmoidal have allergic or other factors as cause for their origin. 

Number- only one antrochoanal polyp usually is present, whereas ethmoidal is usually multiple in number. 

Laterality - antrochoanal are unilateral, the other kind is bilateral mostly. 

Origin - Antrochoanal begins from the ostium of maxillary sinus but ethmoidal, as the name suggests, originates from the ethmoidal sinuses, uncinate process, middle turbinate and middle meatus. 

Growth - As the name suggests, this polyp grows behind towards the choana and hangs down behind the soft palate. The ethmoidal polyp, grows forward and may present at the nares. 

Size and shape - interestingly, antrochoanal polyps are trilobed with the three parts being antral, choanal and nasal. Ethmoidal are grape- like round masses. 

Recurrence - antrochoanal has lesser chance of recurrence as compared to ethmoidal polyps. 

Treatment - antrochoanal polyps are removed by polypectomy, endoscopic removal or Caldwell-Luc operation. Ethmoidal polyps are treated by ethmoidectomy, polypectomy or endoscopic surgery. 

I hope this has been helpful to you! Best of luck for your studies! 

Also, Fact Fatigue: Polyps growing in the ear, middle ear cavity ones, are never avulsed, because it's dangerous and could lead to damage to the branches of facial nerve passing through the walls of the middle ear.

This mnemonic was written by our Medical Student Guest Author, Devanshi Shah

Read more about MSGAI: http://www.medicowesome.com/2018/01/medical-student-guest-author-internship.html

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