Choanal polyp arises from the maxillary sinus antrum. The resected choanal polyp shown here is similar in color and texture to sinonasal inflammatory polyp. However, it generally arises as a single, unilateral mass with a pedicle (arrow) attached to the maxillary sinus. The polyp can extend posteriorly into the nasopharynx and can be mistaken for a nasopharyngeal tumor.
Choanal polyp is relatively rare lesion representing about 3-6% of all sinonasal polyps. It commonly occurs in male teenagers and young adults as a single, unilateral mass. Patients typically present with nasal obstruction and maxillary sinusitis. The nasopharyngeal obstruction can occur with the extension of polyp posteriorly into the nasopharynx – mimicking a primary nasopharyngeal tumor. Treatment is complete surgical excision – recurrence is common with incomplete resection. Differential diagnosis includes: juvenile nasopharyngeal angiofibroma and sinonasal inflammatory polyp.