Aggressive Sinonasal Polyposis

Abstract

Sinonasal polyposis is one of the most common nasal conditions encountered by the otolaryngologist. Trauma, inflammation, allergy, and chemical irritation are all said to play a role in its etiology. While polyps generally behave in a benign noninvasive manner, they can assume a more aggressive course. We recently encountered three cases of histologically benign inflammatory sinonasal polyps which acted in an aggressive manner by eroding bone and invading orbit, pterygomaxillary space, and anterior cranial fossae. After appropriate cranial facial surgical therapy, all three of these patients recovered completely. The mechanism responsible for aggressive clinical behavior in these cases may be related to the formation of multiple, microscopic, intrapolyp mucoceles. Aggressive sinonasal polyposis should be considered when lesions of the paranasal sinus are encountered in clinical practice.