How to manage Nasal Polyps in children? - Dr. Sreenivasa Murthy T M скачать в хорошем качестве

How to manage Nasal Polyps in children? - Dr. Sreenivasa Murthy T M

We need to understand what polyps are, what is the difference between polyps in children, what is the difference in adults and then maybe we can have an understanding of how it can be managed. Polyps are basically outgrowths of the lining of the nasal mucosa or the sinus mucosa and if it is from the sinus, it comes out of the sinus through small holes which are the natural draining pathways, and they come to lie in the nasal cavity. Now all of this, doesn’t happen overnight. Today night my child has slept well, tomorrow morning my child has a polyp. It doesn’t occur like that. It takes atleast a few months for polyps to develop from a given normal situation. The most common reasons for adults for polyp formation would be either allergy or an infection or a combination of the two. Very rarely tumors can present like a polyp which we will be able to know once we do further investigation, whether it is a polyp or not a polyp. Now in children, we need to be a little bit more careful. We need to be sure that the polyp is from one side or both sides. If it is from both sides, then it is generally due to infections or an allergic manifestation. But if it is only one side, we need to be doubly, doubly careful because sometimes they can have herniated meninges. Meninges are covering of the brain. That is what we call as a meningocele and masquerade as a polyp in the nose on one side. Now in most polyps will respond to medication and may not require a surgery. But in occasional patient with allergy of long standing, not treated adequately may not respond, and I such a situation we may recommend surgery. Infective origin polyps rarely respond to medication and they will require surgery. Now conditions other than polyps which can masquerade as polyps, when we see in the clinic, it will look like a polyp. But on further imaging, that is like doing a CT scan or an MRI, we will get further details. They may turn out to be something totally different from what we had anticipated in the clinic. So one of the conditions being a meningocole. Sometimes it can be a tumor. Sometimes it can be malignancies, which is very rare, but meningocoles can masquerade as polyps which we need to be careful about, and these conditions need surgical correction. So I think, by and large allergic polyps, most other polyp like situations, you will require surgery.