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Choanal polyps: one entity, one surgical approach?

Twenty consecutive patients (ten women and ten men; 14 - 66 years old) operated on from September 1993 to November 1995 were included in this study. The only inclusion criterion was a large polyp protruding from the nasal cavity into the nasopharynx. CT, MRI and endoscopic sinus surgery identified sites of choanal polyp (CP) origin as follows: maxillary sinus (n = 11), sphenoid sinus (n = 3), posterior ethmoids (n = 4), anterior ethmoids (n = 1), and lateral aspect of the head of the middle turbinate (n = 1). Light microscopy demonstrated no correlation between the site of CP attachment and its morphological appearance, but in two cases of CP (one originating from the sphenoid sinus and the other form the middle turbinate) morphological examination confirmed the diagnosis of inverted papilloma. Long-term follow-up in 15 patients revealed no cases of recurrence. The results obtained allow us to define three types of CP: antrochoanal, sphenochoanal, and ethmochoanal. In case of an unusual site of CP origin, the diagnosis of inverted papilloma should be considered.