UPSC-CMS 2018 — ENT

Q: Antro-choanal polyp always arises from:

Maxillary sinus. ***Maxillary sinus*** - An **antro-choanal polyp** (ACP) characteristically originates from the **mucosa of the maxillary sinus**, typically protruding through the ostium into the nasal cavity. - The name "antro-choanal" itself signifies its origin in the **antrum** (maxillary sinus) and its extension to the **choana** (posterior nasal aperture). *Posterior end of the septum* - Polyps do not typically arise from the **septum**; nasal polyps more commonly originate from the lateral nasal wall or paranasal sinuses. - The septum is primarily composed of cartilage and bone and does not have the same mucociliary lining susceptible to polyp formation as the sinuses. *Nasopharynx* - While an antro-choanal polyp may extend into the **nasopharynx**, it does not originate there. - The nasopharynx is a common endpoint for the polyp's growth, but its actual point of attachment is in the maxillary sinus. *Posterior ethmoidal cells* - Polyps can arise from **ethmoidal cells** (ethmoidal polyps), but these are distinct from antro-choanal polyps and do not typically grow to occupy the choana. - Ethmoidal polyps are usually multiple and bilateral, whereas antro-choanal polyps are typically solitary and unilateral. [Practice more ENT PYQs on OnCourse]

Q: Which one of the following regarding Nasal polyps is NOT true?

Nasal polyps are very painful to touch. ***Nasal polyps are very painful to touch*** * **Nasal polyps** are typically **painless** and soft to the touch, as they are edematous mucosal outgrowths. * Pain associated with **nasal polyps** usually indicates a secondary complication such as **infection** or, rarely, **malignancy**, rather than the polyps themselves. * *Meningocele must be excluded in children with polyps* * **Meningoceles** or **encephalocele** are important considerations in children presenting with **nasal masses**, as they represent a protrusion of brain tissue or meninges and resemble polyps. * Their exclusion is critical due to the risk of **meningitis** during surgical intervention if misdiagnosed as routine polyps. * *Bleeding polyp may indicate malignancy* * While polyps are generally not prone to bleeding, the presence of **unilateral**, **bleeding**, or **friable polyps** raises suspicion for **malignancy**, such as **nasopharyngeal carcinoma** or **sinonasal cancers**. * Any atypical presentation, especially with ulceration or persistent epistaxis, warrants **biopsy** and further investigation. * *Simple polyps are bilateral* * **Simple inflammatory polyps** (e.g., from **chronic rhinosinusitis** with nasal polyps) are most commonly found **bilaterally**. * Unilateral polyps or masses, especially in adults, should prompt suspicion for other causes, including **neoplasms**. [Practice more ENT PYQs on OnCourse]

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Antro-choanal polyp always arises from:

Which one of the following regarding Nasal polyps is NOT true?

UPSC-CMS 2018 - ENT UPSC-CMS Practice Questions and MCQs

Question 1: Antro-choanal polyp always arises from:

A. Posterior end of the septum
B. Nasopharynx
C. Maxillary sinus (Correct Answer)
D. Posterior ethmoidal cells

Explanation: ***Maxillary sinus*** - An **antro-choanal polyp** (ACP) characteristically originates from the **mucosa of the maxillary sinus**, typically protruding through the ostium into the nasal cavity. - The name "antro-choanal" itself signifies its origin in the **antrum** (maxillary sinus) and its extension to the **choana** (posterior nasal aperture). *Posterior end of the septum* - Polyps do not typically arise from the **septum**; nasal polyps more commonly originate from the lateral nasal wall or paranasal sinuses. - The septum is primarily composed of cartilage and bone and does not have the same mucociliary lining susceptible to polyp formation as the sinuses. *Nasopharynx* - While an antro-choanal polyp may extend into the **nasopharynx**, it does not originate there. - The nasopharynx is a common endpoint for the polyp's growth, but its actual point of attachment is in the maxillary sinus. *Posterior ethmoidal cells* - Polyps can arise from **ethmoidal cells** (ethmoidal polyps), but these are distinct from antro-choanal polyps and do not typically grow to occupy the choana. - Ethmoidal polyps are usually multiple and bilateral, whereas antro-choanal polyps are typically solitary and unilateral.

Question 2: Which one of the following regarding Nasal polyps is NOT true?

A. Nasal polyps are very painful to touch (Correct Answer)
B. Meningocele must be excluded in children with polyps
C. Bleeding polyp may indicate malignancy
D. Simple polyps are bilateral

Explanation: ***Nasal polyps are very painful to touch*** * **Nasal polyps** are typically **painless** and soft to the touch, as they are edematous mucosal outgrowths. * Pain associated with **nasal polyps** usually indicates a secondary complication such as **infection** or, rarely, **malignancy**, rather than the polyps themselves. * *Meningocele must be excluded in children with polyps* * **Meningoceles** or **encephalocele** are important considerations in children presenting with **nasal masses**, as they represent a protrusion of brain tissue or meninges and resemble polyps. * Their exclusion is critical due to the risk of **meningitis** during surgical intervention if misdiagnosed as routine polyps. * *Bleeding polyp may indicate malignancy* * While polyps are generally not prone to bleeding, the presence of **unilateral**, **bleeding**, or **friable polyps** raises suspicion for **malignancy**, such as **nasopharyngeal carcinoma** or **sinonasal cancers**. * Any atypical presentation, especially with ulceration or persistent epistaxis, warrants **biopsy** and further investigation. * *Simple polyps are bilateral* * **Simple inflammatory polyps** (e.g., from **chronic rhinosinusitis** with nasal polyps) are most commonly found **bilaterally**. * Unilateral polyps or masses, especially in adults, should prompt suspicion for other causes, including **neoplasms**.