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Abstract: Nasal polyps are common rhinological diseases, and the etiology is not very clear. This article presents a 10-year-old male child who came to the clinic with nasal congestion. After detailed questioning about the condition, a CT examination was performed and a nasal polyp was found in the posterior nostril of the maxillary sinus. The nasal polyp was successfully removed and postoperative treatment with medication and nasal irrigation improved the symptoms of nasal congestion.
Basic information】Male, 10 years old
Disease Type】Nasal polyp
Hospital】Northern War Zone General Hospital
Date of consultation】July 2021
Treatment plan】Surgical treatment (nasal endoscopic polypectomy of the posterior nasal aperture of the maxillary sinus) + intravenous medication (cefazolin sodium for injection) + nasal irrigation
Treatment period】1 week hospitalization, 1 month outpatient follow-up
Results】The nasal polyps were successfully removed, the nasal congestion improved, and the patient could sleep normally at night.
I. Initial consultation
The family said that the child had nasal congestion 6 months ago, often felt something in the nasal cavity, yellow pus nasal discharge and foul smell of nasal mucus, and blood in the nasal mucus when blowing hard. For further diagnosis, she came to our department. On examination, a grayish-white smooth mass was seen in the nasal cavity, extending backward from the middle nasal passage.
II. Treatment history
After admission to the hospital, we actively improved the routine pre-surgical examination, including routine blood count, coagulation items, chest X-ray, liver and kidney function, etc. There was no absolute contraindication to surgery, so we arranged to perform nasal endoscopic polypectomy of the posterior maxillary sinus under general anesthesia, and the polyp was seen to obstruct the maxillary sinus orifice and hang backward into the nasopharynx, and there was a large amount of yellow pus on the surface of the polyp. After treatment of the polyp, the right maxillary sinus opening was enlarged and saline was flushed repeatedly. After the operation, the polyp was carefully inspected in the nasal cavity without residue, and the nasal cavity was filled with a tumescent sponge, which served as a pressure to stop the bleeding. After the operation, the child was given cefazolin sodium for injection for anti-inflammatory treatment, and then further nasal irrigation treatment was performed after the nasal stuffing was removed.
III. Treatment results
After the nasal polyps were successfully removed and the nasal stuffing was removed, the child said that the nasal congestion was better than before the operation, but there was still a lot of secretion coming out of the nose, he could sleep normally at night, no open mouth breathing, and there was no more odor in the nose. With further nasal irrigation and anti-inflammatory and anti-swelling treatment, the above discomfort symptoms would gradually improve.
IV. Notes
We are glad that the nasal polyp was successfully removed after the surgery and the discomfort symptoms improved significantly after the surgery. The child was advised to supplement nutrition, avoid strenuous exercise, and follow the doctor’s instructions for regular review.
1.Eat more high-protein foods, such as meat and eggs, and try not to eat particularly spicy and greasy foods.
2.Tell the child not to run and jump at will, excessive activity may easily lead to nasal bleeding, and heavy bleeding may require another general anesthesia operation.
3. It is necessary to return to the hospital several times within 1 month after the operation for review. The specific time of review should be determined according to the recovery of the operation area, avoid going to crowded places to reduce bacterial and viral cross-infection and prevent colds.
V. Personal insight
Nasal polyps are common in adolescents, parents must not arbitrarily give the affected children medication, need to go to the hospital to improve the relevant examination, and then consider further treatment options after the diagnosis. After the surgery, it is necessary to return to the hospital for a follow-up examination and review the nasal endoscope to clarify the recovery of the operated area to avoid mucosal adhesions in the operated area, which may affect breathing, and if there are minor adhesions, they need to be released in a timely manner.