Inflammatory Polyp Arising From the Inferior Turbinate

A 65-year-old healthy man was referred to our department for evaluation of a mass originating from right inferior turbinate, which was found incidentally during the treatment of acute rhinosinusitis at local clinic. He complained of purulent rhinorrhea, cough, and nasal obstruction. Among these symptoms, nasal obstruction had progressively worsened over 3 months. He denied any history of underlying diseases, facial trauma, or nasal surgery.

Endoscopic examination of the right nasal cavity revealed a whitish, polypoid, irregular surfaced, and rubbery mass arising from the inferior turbinate (Figure 1). Computed tomography showed a 1 × 1 cm sized, poorly enhancing, soft tissue mass attached to the midportion of right inferior turbinate without bone erosion and bilateral maxillary sinusitis (Figure 2). The patient underwent transnasal endoscopic resection of the mass under local anesthesia (Figure 3). Before local injection, we confirmed the mass was attached to the inferomedial portion of the inferior turbinate in a pedunculated type. After the mass was resected with cold instrumentation, the tumor bed was cauterized with monopolar. Surgical pathology was consistent with inflammatory polyp. There has been no evidence of recurrence at the 6-month follow-up.

Figure 1.

Endoscopy reveals a whitish, polypoid, irregular surfaced, and rubbery mass arising from the right inferior turbinate. A, Endoscopic view at the initial visit. B, Endoscopic view after applied with 10% xylocaine-soaked pledgets 30 minutes before surgery.

Figure 2.

Nonenhanced axial (A), enhanced axial (B), and enhanced coronal (C) computed tomography images of the nose and paranasal sinuses show a poorly enhanced homogenous mass attached to midportion of the right inferior turbinate (arrow and asterisk: mass).

Figure 3.

Gross finding of the removed mass, measure about 14 mm × 8 mm.

A variety of infectious, inflammatory, neoplastic, and vascular lesions may affect the inferior turbinates. ¹ Although it is not data limited to the inferior turbinate, inflammatory polyps are by far the most common accounting for nearly 70% of sinonasal benign tumors. ²

Otolaryngologists routinely examine the inferior turbinates with nasal endoscopy in patients with nasal symptoms. Because of how routinely examined and accessible these structures are, otolaryngologists can diagnose benign lesions of the inferior turbinate early. ¹ So, the knowledge of endoscopic findings of inflammatory polyp arising from the inferior turbinate can help the early diagnosis and treatment.

The treatment modality of inflammatory polyp arising from the inferior turbinate is complete excision with some of the surrounding normal tissue by transnasal endoscopic approach. ¹ This report can potentially improve clinicians’ knowledge of benign tumors of inferior turbinate and be helpful in making early diagnosis and treatment at the first clinic visit.