Sinonasal Polyposis and Choanal Atresia in a Single Patient Exterminate the Theory of Aerodynamics: A Case Report

Abstract

Diferent theories have been proposed for the pathogenesis of sinonasal polyposis, However, there is no consensus of opinions on a single widely accepted theory. This case, which demonstrates nasal polyp formation within an atretic nasal cavity, suggests that the aerodynamic theory may have little efect in the pathogenesis of sinonasal polyposis. A 29-year-old female sufered a long history of nasal obstruction mainly on the left side. Nasal endoscopic evaluation showed bilateral nasal polyposis with unilateral choanal atresia. She had a history of nasal surgery for nasal polyposis, atresia repair, and septoturbinoplasty with recurrence of symptoms 2 years later. Revision functional endoscopic sinus surgery and choanal atresial repair are done with the polyps’ histopathological evaluation showing allergic nasal polyps. The formation of nasal polyps within an atretic nasal cavity suggests that the airfow and inhaled allergen-based explanation of nasal polyposis may have little to do with polyp formation at least in some patients and needs further evaluation. This leaves the door open for the many other possible etiologies.