0:00

There is one unique polyp I would like

0:03

to mention that's called the antrochoanal polyp.

0:06

The antro refers to the maxillary sinus antrum,

0:09

and the choanal refers to the nasal

0:12

pharyngeal, or pharyngeal nasal cavity choanae.

0:15

This is a polyp, which arises in the maxillary

0:18

sinus and then extends into the nasal cavity and

0:20

potentially posteriorly to the nasopharynx.

0:23

It's usually a solitary

0:25

polyp, and it usually erodes the

0:28

medial wall of the maxillary antrum.

0:30

It may extend into the inferior

0:32

accessory ostium of the maxillary sinus.

0:36

This is a polyp, which is,

0:37

as I said, usually singular.

0:39

So it's not associated with polyposis, but it

0:42

does usually have homogeneous density, often

0:46

lower density than typical inflammatory disease.

0:50

So here is an example of that

0:54

antrochoanal polyp, where you see the opacification of

0:57

the maxillary antrum with a soft tissue mass,

1:00

which is extending into the nasal cavity.

1:03

The pedicle is usually along the inner wall of

1:05

the maxillary sinus, and it may emerge from the

1:09

accessory ostium, which is usually inferior to the

1:13

more superior natural ostium of the maxillary sinus.

1:17

When you have it, it may extend posteriorly to the

1:20

back of the nasopharynx in an ipsilateral fashion.

1:25

This is such a large one that,

1:26

posteriorly, it actually crossed the midline.

1:29

This is an entity that is usually seen in

1:31

young adults or teenagers and is a relatively

1:35

characteristic type of polyp—unilateral,

1:38

solitary polyp that you will

1:39

find in the sinonasal cavity.

1:42

As we've continued to discuss sinusitis and potential

1:46

etiologies of it and complications, I do want to mention

1:50

that odontogenic disease can lead to sinusitis itself.

1:56

So remember, as we are looking at our paranasal

1:59

sinuses, to look at the maxilla and the maxillary

2:04

teeth, to identify whether or not there is

2:06

endodontal or periodontal inflammatory change

2:11

associated with the teeth. In those patients who

2:14

have severe dental caries with endodontitis or

2:16

periodontal inflammatory condition, you may see

2:20

reactive inflammatory change in the inferior maxillary

2:24

antrum associated with odontogenic sinusitis.