Obstruction on one side
One half of the nose gradually stops breathing.
CONDITION / CARRY
Choanal polyp.
Choanal (antrochoanal) polyp is a benign formation that grows from the maxillary sinus and exits through the back opening of the nose into the nasopharynx. It is almost always unilateral and is treated only surgically — endoscopically, through the nose.
CONCEPTUAL VISUALIZATION- what is it
- A benign polyp growing from the maxillary sinus and extending into the nasopharynx.
- To whom does it concern?
- Most often children and young adults; almost always only on one side.
- How to treat
- Only surgically: the polyp is removed endoscopically along with its base in the sinus.
- Who treats
- ENT surgeon.
01 / WHAT IS ITWhat is
What is
choanal polyp.
Choanal or antrochoanal polyp is a benign cystic formation. It begins in the maxillary sinus, exits through the opening of the sinus into the nasal cavity and then grows back to the choana, the back opening of the nose, and sometimes hangs down in the pharynx.
It is not a tumor and is not the same as polyps in polyposis rhinosinusitis. They are usually bilateral and multiple, and the choanal polyp is single and on the same side.
Medicines do not reduce polyps, so the treatment is always surgical. The main task is to remove not only the visible part in the nose, but also the base in the sinus, otherwise it will return.
This is general information. How to treat you, the doctor will tell you after the endoscopy and CT scan.
02 / SIGNSHow a
How a
polyp manifests itself.
The most frequent complaint is congestion: in a series of 38 patients it was present in 97.4%, in a series of 94 patients - all.
Allocation
Mucus from the nose or running down the back of the pharynx; in a series of 94 patients — in 57.4%.
Hoarseness and snoring
A polyp in the nasopharynx changes the voice and prevents breathing in sleep.
Visible in the throat
In children, the polyp hangs more often in the pharynx: in 27% of children against 7% of adults.
03 / REASONSWhy it
Why it
occurs.
The exact cause is unknown. Polyps are more often found in people with chronic inflammation of the nose and sinuses.
Chronic inflammation
Chronic sinusitis and allergic rhinitis are considered the most frequent contributing factors.
Chronic sinusitisThe structure of the nose
In a series of 34 patients, the curvature of the septum was in half, and the conchas were enlarged in 32.3%.
Distortion of the septumage
Most often — children and young adults: in a series of 38 patients, the median age is 23.5 years.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
A choanal polyp grows slowly and usually does not require emergency care. But one-sided congestion always needs to be examined: other formations in the nose can manifest themselves in the same way.
103 immediately if:
- nose bleeding does not stop after 15 minutes of pressing;
- the child suffocates in his sleep or cannot swallow due to formations in the throat.
See an ENT doctor in the coming days if:
Only one side is closed, and bloody discharge, facial pain or numbness appeared from it. If one half of the nose gradually stops breathing, make an appointment for a scheduled consultation.
05 / DIAGNOSTICSHow it
How it
is detected.
- Nasal endoscopy
The doctor sees a smooth formation that goes from the sinus to the choana.
- CT scan of the sinuses
Shows where the polyp in the maxillary sinus is growing from is the main thing for the operation plan.
- Examination of the pharynx
In children, a large polyp is sometimes visible if you look into the mouth: it hangs behind the soft palate.
- Histology
The removed tissue is examined to confirm benignity.
06 / TREATMENTHow to remove
How to remove
choanal polyp.
Treatment is always surgical. The most important thing is to completely remove part of the polyp in the sinus along with its base.
01
Endoscopic surgery
The main method is through the nose, without incisions on the face.
- Antrostomy through the middle nasal passage
- The natural opening of the maxillary sinus is expanded and the polyp is removed along with the base. In a review of 439 adults, 80.8% underwent this operation.
- Shaver
- The rotary tool helps to completely remove the tissue in the sinus.
- Additional access
- If the base is not visible through the nose, access is added through the lower nasal passage, the prelacrimal niche, or the front wall of the sinus.
02
The result
- Relapse in adults
- According to a review of 16 studies (439 patients), the polyp returned in 9% at an average follow-up of 36.8 months.
- Relapse in children
- In the review of 13 studies (285 children) — in 15.0%; polyps return more often in children.
- Children and adults
- In a study of 56 patients, the operation was successful in 88.9% of children and 93.1% of adults.
- Observation
- Control at least 2 years after surgery: during this time, 95% of recurrences are detected.
07 / AT THE VALIKHNOVSKY CLINIC
How do we
How do we
treat it.
A choanal polyp at Dr. Valikhnovsky's Institute of Surgery is removed in the "New Nose" direction - endoscopically, together with the base in the maxillary sinus.
DIRECTION TO THE CLINIC
A new nose
Shape, support and breathing of the nose: septum, concha, sinuses, consequences of injuries, failed operations and removal of tumors.
Go to direction
What do we do in this condition
- Endoscopic removal of a choanal polyp — through the nostrils, together with the part in the sinus.
- Endoscopic microhygrotomy — expansion of the opening of the maxillary sinus for full access to the base of the polyp.
- Shaver polypotomy — a rotating instrument under the control of an endoscope.
Rostislav Valikhnovsky
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovsky Institute of Surgery.
How is the treatment in us
- ConsultationConversation, examination, endoscopy of the nose.
- CT scan of the sinusesShows where the polyp is growing from and how to remove it completely.
- PlanAccess and volume of operation; for children - taking into account age.
- OperationEndoscopic removal through the nostrils; the tissue is sent for histology.
- ControlExaminations with endoscopy at least 2 years to avoid recurrence.
08 / QUESTIONS AND ANSWERSFrequently asked
Frequently asked
questions.
Short answers. What is right for you, the doctor will tell you during the consultation.
Can a choanal polyp be cured with medication?
No. Treatment of choanal polyp is always surgical; sprays can reduce the accompanying inflammation, but the polyp remains.
How is a choanal polyp different from ordinary polyps in the nose?
It is one, grows from the maxillary sinus and almost always on one side. Polyps in polyposis rhinosinusitis are usually multiple and bilateral.
Can the polyp come back?
Yes: according to reviews, 9% of adults and 15.0% of children. The main way to avoid this is to completely remove the base of the polyp in the sinus.
How much should be observed after the operation?
At least 2 years: during this time, 95% of relapses are detected.
Are children operated on?
Yes. In children, the polyp is often large and hangs in the pharynx; in a study of 56 patients, all children underwent endoscopic surgery.
Does the result depend on access?
Yes. In a review of studies in children, a combination of endoscopic and additional access resulted in 0% recurrence versus 17.7% after endoscopic surgery alone. But not everyone needs combined access — only when the base of the polyp is not visible through the nose.
Is choanal polyp dangerous?
This is a benign formation. But the removed tissue is always examined, and one-sided obstruction should not be dismissed as a polyp without examination.
Sources
10 sources · reviews, guidelines and studiesShowCollapse
- Maxillary Sinus Antrochoanal Polyp Recurrence Following Surgery in Adults: A Systematic ReviewLaryngoscope, 2026doi:10.1002/lary.70125 ↗
- Recurrences of surgery for antrochoanal polyps in children: A systematic reviewInternational Journal of Pediatric Otorhinolaryngology, 2018doi:10.1016/j.ijporl.2017.12.035 ↗
- Evaluation and management of antrochoanal polypsClinical and Experimental Otorhinolaryngology, 2010doi:10.3342/ceo.2010.3.2.110 ↗
- Difference of antrochoanal polyp between children and adultsInternational Journal of Pediatric Otorhinolaryngology, 2016doi:10.1016/j.ijporl.2016.03.004 ↗
- Antrochoanal Polyps: How Long Should Follow-Up Be after Surgery?International Journal of Otolaryngology, 2015doi:10.1155/2015/297417 ↗
- Antrochoanal polyposis: analysis of 34 casesEuropean Archives of Oto-Rhino-Laryngology, 2013doi:10.1007/s00405-012-2274-2 ↗
- Antrochoanal polyps: report of 94 cases and review the literatureNigerian Journal of Medicine, 2012pubmed.ncbi.nlm.nih.gov/23311182 ↗
- Endoscopic Inferior Meatal Antrostomy for Antrochoanal Polyps: A Long-Term Follow-UpORL, 2022doi:10.1159/000518279 ↗
- Transnasal Prelacrimal Recess Approach for Recurrent Antrachoanal PolypJournal of Craniofacial Surgery, 2016doi:10.1097/SCS.0000000000002699 ↗
- Choanal polyps in children and adults: 10-year experience from a tertiary care hospitalEuropean Archives of Oto-Rhino-Laryngology, 2019doi:10.1007/s00405-018-5208-9 ↗
The figures on the page are from these sources.
One half
of the nose does not breathe?
Describe the complaints or send a CT scan if you have one. The doctor will tell if it is a polyp and how to remove it.