Nasal Polyps in Children

Nasal Polyps are common nasal swellings or masses seen in children.

The paranasal sinuses (“the sinuses”) are air-filled cavities located within the bones of the face and around the nasal cavity and eyes. 

Each sinus is named for the bone in which it is located:

Maxillary sinus- one sinus located within the bone of each cheek  

Ethmoid sinus- located under the bone of the inside corner of each eye, although this is often shown as a single sinus in diagrams   this is really a honeycomb-like structure of 6-12 small sinuses that is better appreciated on CT scan images through the face  

Frontal- one sinus per side, located within the bone of the forehead above the level of the eyes and nasal bridge  

Sphenoid- one sinus per side, located behind the ethmoid sinuses; the sphenoid is not seen in a head-on view but is better appreciated looking at a side view

However in children sinuses are still developing and when we refer to sinuses in children;it is mainly maxillary and ethmoids.

Nasal polyps in children can be inflamatory (bacterial),allergic or associated with cystic fibrosis. 

The nasal polyps are of two kinds mainly : Antrochoanal or Sinonasal.

Antrochoanal are ususally single polyps aising from the maxillay antrum and going towards the choana (posterior opening of nostrils).They are usually one sided.

Sinonasal usually arise from the sinus lining of both sides of sinuses.

The common symptoms of polyps are 

nasal block

obstructive sleep apnoea or snoring in children

sometimes nose bleed

Usually the ENT surgeon will ask for CT scan to know the extend of disease.

The nasal polyps require surgical removal.Nowadays in children it is usually endoscopic approach.Sometimes transoral and other approaches are require for complete removal.

As a surgeon,I always consider the growing anatomy of sinuses,unerupted teeth and concern for facial growth in children while deciding the surgery.