The incidence of significant pathology in patients presenting with benign-appearing unilateral nasal polyps.

OBJECTIVE

The presentation of unilateral nasal polyps traditionally necessitates histological evaluation for a neoplasm. This study sought to determine the rates of significant pathology in patients presenting with benign-appearing unilateral nasal polyps, to inform practice.

METHOD

All patients who underwent nasal polypectomy for benign-appearing unilateral nasal polyps over a 13-year period were included.

RESULTS

A total of 77 patients were included. On histology, 60 cases (77.9 per cent) were found to be inflammatory polyps. Thirteen cases were neoplastic, of which 11 (14.3 per cent) were benign and 2 (2.6 per cent) were malignant neoplasms. The following significant pathologies were found: Schneiderian papillomas, in 10 cases (13.0 per cent); neurofibroma, in 1 case (1.3 per cent); adenoid cystic carcinoma, in 1 case (1.3 per cent); and malignant melanoma, in 1 case (1.3 per cent).

CONCLUSION

Our data support routine histological assessment for all unilateral nasal polyps. Malignancy is rare (2.6 per cent) in patients presenting with benign-appearing unilateral nasal polyps. In elderly, unfit patients with minimal symptoms, initial conservative management may be reasonable.