Choanal polyp

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.