Nasal Polyposis in Children: A Differential Diagnosis and Algorithm

The aetiology of many paediatric nasal polyps is not known; however, it is vital to make a diagnosis in order to help patients wherever possible. The term “a nasal polyp” is not a diagnosis but a sign of inflammation of the lining of the nose that can be due to a range of significant diseases. The main differential diagnoses are an antrochoanal polyp, cystic fibrosis, primary ciliary dyskinesia, immunodeficiency, chronic infection, allergic aspergillosis, inverted papilloma, haemangioma, angiofibroma, encephalocoele, a nasal glioma or malignancy. Antrochoanal polyps result from mucosal retention cysts in the maxillary sinus that have prolapsed either through the infundibulum or accessory ostia. The best way of reducing the chance of them recurring is to remove the mucosa around their base so that a scar tissue forms and they do not recur. The management of paediatric polyposis is often disappointing because apart from those with an antrochoanal polyp, the recurrence rate is high.