Sphenocoanal Polyp in an 8-Year-Old Child

Introduction: Sphenochoanal polyp is an entity originated in the sphenoid sinus cavity extending to the choana of rare occurrence, and even rarer in children. Clinical presentation is similar to the antrochoanal polyp, and radiologic studies are necessary to distinguish them.

Objective: The study aims to show the importance of endoscopic examination and radiologic studies before antrochoanal polyp surgery.

Resumed Report: We present the case of an 8-year-old child with a 4-month story of permanent unilateral nasal obstruction, and a polyp completely obliterating the left nasal cavity. On computed tomography (CT) scan, the obliteration of the maxillary and left sphenoid was observed. Although an endoscopy was performed before surgery, it was impossible to identify the origin because of a narrow nasal fossa and patient discomfort. During endoscopic surgery after opening the sinus and anterior ethmoid cells, a posterior deployment of the polyp was evidenced, with its root in the floor of sphenoid sinus. The differential between sphenochoanal and antrochoanal polyps is possible with CT of paranasal sinuses, which is performed routinely in the case of polyps. It would show opaque sphenoid sinus and choana with free maxillary sinus. In this case, it was observed that opacification of both attributed to a recent sinus infection and adenoid hyperplasia.

Conclusion: Clinical evaluation with rigid nasal endoscopy and CT scan is mandatory to diagnose sphenochoanal polyp, avoiding unnecessary exploration of maxillary sinus and inadequate surgery for an antrochoanal polyp.