Nasal Polyps in Children
By: Paul FryattTotal Views: 275, Word Count: 504,
Nasal polyps in children are kind pedunculated tumors formed from edematous, generally chronically inflamed nasal mucosa. They normally arise from the ethmoidal sinus and are present in the middle meatus. Occasionally, they appear within the maxillary ant rum and could extend to the nasopharynx. Whereas antrochoanal polyps represent only 5 to 7% of all nasal polyps in the general population, they represent about 34% in the pediatric population.
Etiology
Cystic fibrosis is the most general childhood cause of nasal polyposis and must be alleged in any child more than 12 years old with nasal polyps, even in the absence of typical respiratory and digestive symptoms; as many as 30% of children with cystic fibrosis obtain nasal polyps. Nasal polyposis is also linked with chronic sinusitis and allergic rhinitis. In the uncommon Sumter triad, nasal polyps are linked with asthma and aspirin sensitivity.
Clinical Manifestations
Obstruction of nasal passages is prominent with linked hypo nasal speech and mouth breathing. Mucopurulent rhino rhea or profuse unilateral mucoid could also be present. An examination of the nasal passages shows gray, glossy grapelike masses squeezed between the septum and the nasal turbinates.
History
The signs of nasal polyps in children depend on the size of the polyp. Small polyps might not produce symptoms and could be identified only during routine examination when they are forward to the anterior edge of the middle turbinate. Polyps located later to the site are not typically seen during routine anterior rhinos copy examination performed with an otoscope and are missed unless the child is symptomatic. Small polyps in areas where polyps generally arise (i.e. the middle meatus) could produce symptoms and block the outflow tract of the sinuses, causing recurrent or chronic acute sinusitis symptoms.
Symptom producing polyps could cause nasal airway hindrance, dull headaches, postnasal drainage, snoring and rhino rhea. Linked hyposmia or anosmia might be a hint that polyps rather than sinusitis alone are present. Epitasis that does not arise from irritation of the anterior nasal septum generally does not occur with kind multiple polyps and might suggest other more severe nasal cavity lesions.
Massive polyposis or a single large polyp that obstructs the nasal could cause chronic mouth breathing and obstructive sleep symptoms.
Causes
As described in a path physiology, chronic inflammation apparently has a primary role in the pathogenesis of nasal polyps in children. Multiple polyps occur in kids with chronic sinusitis, allergic rhinitis, AFS and CS. An isolated polyp could be an antral choanal polyp, a benevolent huge polyp, a nasolacrimal duct cyst or any congenital lesion or benign or malignant tumor.
Treatment
Local or systemic decongestants are not generally effective in lessening the polyps, although they could provide symptomatic relief from the linked mucosal edema. Intranasal steroid sprays and at times systemic steroids might provide some shrinkage of nasal polyps with symptomatic relief and have proved useful in kids with cystic fibrosis and nasal polyps.
Polyps must be removed surgically in total obstruction, unrestrained rhino rhea or irregularity of the nose appears
About the Author
Paul Fryatt, M.D. has been in this profession from last 24 years. He made great achievements in his profession. He made an initiative to open a Family Allergy Clinic in 1985 to help his patients who were not reacting to traditional allergy treatment programs. Moreover he has explored the treatment to overcome allergy symptoms to reclaim quality of life through his convenient, no-shots therapy.
Advice Rating: Not yet rated
Login to vote