A 12-year-old boy has long-standing unilateral purulent nasal discharge and nasal obstruction. Endoscopy shows a single smooth greyish polyp emerging behind the middle turbinate and passing into the nasopharynx. CT shows opacification of one maxillary sinus with extension through an accessory ostium. Which statement about this lesion is correct?
- A It arises from the ethmoid labyrinth and is usually bilateral
- B It typically originates in the maxillary antrum and exits through the accessory or natural ostium toward the choana ✓
- C It is associated with cystic fibrosis in the majority of cases
- D It requires combined external Caldwell-Luc approach with intranasal polypectomy as first-line treatment
Correct answer: B. It typically originates in the maxillary antrum and exits through the accessory or natural ostium toward the choana
Explanation
The antrochoanal polyp (Killian polyp) is a solitary benign polyp arising from maxillary antral mucosa, passing through the accessory or natural ostium into the nasal cavity and thence to the choana, typical of children and young adults with unilateral symptoms. It is unrelated to allergy or cystic fibrosis in most cases, and complete endoscopic excision including the antral portion is curative, so Caldwell-Luc is no longer standard.
Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.