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What Causes Solitary Polyp In The Maxillary Sinus?

Posted on Tue, 3 Feb 2015

Question: hello. I am very scared that I have a malignancy in my sinus. My doctor did a ct scan 6 months ago and told me that i have a cyst in my left maxillary sinus. My symptom then was blocked nostril on the side where the cyst was and runny nose. Since then my symptoms have gotten better, I can now breathe with my mouth closed but I have had spotty blood on the left side. this is my area of concern. I can still feel the cyst and when I breathe on that side it definitly is still blocked just not as severe.
I have a copy of my ct scan if needed.

thank you

Answered by Dr. Naveen Kumar Nanjasetty (43 minutes later)

Brief Answer:
Solitary maxillary cyst or polyp, in your age is not a sign of malignancy..

Detailed Answer:
Hi,

Thanks for posting the query. I have gone through the query, understood your problem and I will try my best to help you with this.

Relax! In your age, a solitary polyp in the maxillary sinus is not a sign of malignancy. It is a sign of allergic nasal condition. As your nose block is partially cleared, the cyst will start resolving automatically.

Nasal bleed could be either due to the dry nose or presence of nasal congestion. Do not worry! With appropriate measures, this can be completely cured.

My suggestions to you are:
1. Drink plenty of warm water. Warm water helps in hydrating the nasal tissues and thus prevents any cracking of the skin inside the nose.
2. Use saline nasal spray. It functions in the similar as above.
3. Do steam inhalation 2-3 times a day for at least 3 min. Steam reduces the nasal congestion and relieves the nasal block.
4. Avoid forceful blowing of the nose or nose picking.
5. Avoid chilled food and beverages/ smoking/ coffee, if any.

If you would like me to review your CT scan, by all means upload it using the ling on the right side of the page or email it to YYYY@YYYY and ask the tech team to upload it to QueryID: 159390. With the above measures you should be alright. Revert back to me if you have any further queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Naveen Kumar Nanjasetty (1 hour later)

thank you for your quick reply. I've attached part of the ct scan. there are many images, so I will try to send them all.

Answered by Dr. Naveen Kumar Nanjasetty (2 hours later)

Brief Answer:
There is a huge polyp in the floor of the sinus with septal deviation..

Detailed Answer:
Hi

Thanks for writing back

According to this image, there is a polyp in the left maximally sinus, most probably, located in the floor of the sinus. Also, there is a deviated nasal septum to the left side, thus causing the blockage of the osteo-meatal complex, or the entry into the maxillary and the ethmoidal sinuses. Hence, it is important to reduce the nasal blockage, in order to clear the polyp. This may not clear completely with the medicines. Please post the rest of the images; I will give my opinion after seeing them.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi - here are the majority of the images. Thank you so much for your detailed response. I appreciate it immensly.

Answered by Dr. Naveen Kumar Nanjasetty (8 hours later)

Brief Answer:
Could you please repost the images...

Detailed Answer:
Hi

Welcome back

I am sorry! There are no new images seen on my dashboard. Could you re-post them again. I'm extremely sorry for the inconvenience caused to you.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Naveen Kumar Nanjasetty (9 hours later)

Hello, I apologize it didn't upload. There are a lot of files. Also, you mentioned that is was a polyp. I was under the impression that having a polyp on one side is worrisome. Thus the area of my concern..my ent doc also told me over the phone that it was a "small cyst" - whereas you told me it was "huge" Is it possible to tell by the ct scan if it is a polyp, cyst, or malignancy? I have attached most of the scans...hopefully it helps. Again, I appreciate your help so much.

Answered by Dr. Naveen Kumar Nanjasetty (39 minutes later)

Brief Answer:
Cyst is a balloon like structure with smooth surface unlike polyp...

Detailed Answer:
Hi

Thanks for writing back.

I am sorry! I am not able to find the new images. Not an issue; I need to clarify the difference between a cyst and a polyp. Cyst will be a smooth, balloon like structure where as a polyp can have multiple surfaces. Either of the case, the treatment remains the same. And, I can assure you that it is not a sign of malignancy.

I am sorry, if I have scared you by saying that it is a huge polyp. The size is usually compared according to the extent of the maxillary cavity. According to the image, the polyp covers almost 2/3rd of the cavity (the black space seen is the air, grayish looking structure is the polyp)

Steroid nasal spray needs to be used for a duration of 5-6 months. Steroid nasal spray reduces the size of the polyp and also, relieves the nasal block by constricting the edematous nasal mucosa.

Hope this clears your doubts.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Naveen Kumar Nanjasetty (17 minutes later)

Hello, I think it's not allowing me to send multiple files. I've attached a few more that hopefully can help.

I truly appreciate your expertise as you've been so helpful!!!

I plan to have another ct scan now that symptoms have gotten a little better besides the blood when I blow my nose. like you said though, this could be irritation.

Answered by Dr. Naveen Kumar Nanjasetty (14 hours later)

Brief Answer:
All the images show polypoidal changes in the left maxillary sinus...

Detailed Answer:
Hi

Thanks for posting the images. I have examined all of them thoroughly. In my opinion there are polypoidal changes in the left maxillary sinus and it’s not a solitary cyst. Either way, as I mentioned in my previous response, the treatment remains the same.

I am concerned about your health; please do not repeat the CT scan again. The reason is one time exposure to the CT scan is equal to exposure to hundred x-rays. Hence, avoid exposure to the radiation and please take the necessary medicines for at least 5-6 months continuously. Later, you can plan for the surgery if required. Also, please don't blow your nose forcefully, this will damage the tiny blood vessels and lead to oozing of the blood. Use saline nasal spray as frequently as possible. Saline helps in keeping the nasal mucosa moist and prevents bleeding.

Hope this clears your doubts. I wish you good health and good luck.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Naveen Kumar Nanjasetty (8 hours later)

One last question, what does polypoidal changes mean? isn't it very rare to have polyps on just one side? I will continue my treatment and try not to worry. Lastly, my ct scan images will remain private correct?

Answered by Dr. Naveen Kumar Nanjasetty (28 minutes later)

Brief Answer:
Polyp means multiple limbs (shape similar to that of corals or grapes)...

Detailed Answer:
Hi

Welcome back

Polyp means multiple limbs (shape similar to that of corals or grapes). Polypoidal changes means the mucosa of the maxillary sinus has got multiple bulges inside the sinus and engulfing the sinus cavity.

Polyps usually develop behind an obstruction. Hence, in your case the left side of the nose is blocking the ostium of the sinus cavity thus creating the negative pressure inside the sinus cavity and pulling the mucosa constantly. This repeated pulling of the sinus mucosa forms polyps.

I appreciate your decision; please continue with the medicines religiously.

The images posted by you are kept confidential and it can't even be viewed by the other doctors except for me.

I wish you good luck and good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj