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Anatomical Variations Favouring Antrochoanal Polyp Genesis.

Sana Ferchichi1,2, Ghada Kharrat1,2, Chiraz Halwani3,2

  • 1Department of Otolaryngology, Mohamed Taher Maâmouri University Hospital, Nabeul, TUN.

Cureus
|February 12, 2026
PubMed
Summary
This summary is machine-generated.

Antrochoanal polyps (ACP) are linked to specific nasal anatomical variations. Concha bullosa, middle turbinate hypertrophy, and hyperpneumatized ethmoid bulla favor ACP development on the same side, while septal deviation favors the opposite side.

Keywords:
anatomical variantantrochoanal polypcomputed tomographyetiologynasal polyp

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Area of Science:

  • Otolaryngology
  • Rhinosinusology
  • Medical Imaging

Background:

  • Antrochoanal polyps (ACP) are pseudotumors of the nasal cavity with controversial etiopathogenesis.
  • An association between sinonasal anatomical variants and ACP development is suspected but not well-defined.
  • Understanding these variants is crucial for determining ACP formation mechanisms.

Purpose of the Study:

  • To identify specific sinonasal anatomical variations significantly associated with the presence of antrochoanal polyps (ACP).
  • To investigate the relationship between anatomical variants and the side of ACP occurrence.
  • To explore potential precursor relationships between anatomical variations and ACP.

Main Methods:

  • A retrospective, descriptive, and comparative study of 54 patients who underwent surgery for ACP.
  • Analysis of 108 nasal cavities (54 with ACP, 54 contralateral controls) using imaging data.
  • Comparison of the frequency of anatomical variants between ACP-positive and control groups.

Main Results:

  • Septal deviation was the most common variant (72.2%). Concha bullosa (33.3%) was the most frequent middle turbinate variant.
  • Significant associations were found between ACP and concha bullosa, middle turbinate hypertrophy, and hyperpneumatized ethmoid bulla (p<0.05).
  • ACP occurred more frequently on the side opposite to septal deviation (p=0.016), while other variants favored the ipsilateral side. Maxillary sinus volume was larger in the ACP+ group (p=0.00).

Conclusions:

  • Nasal septum deviation promotes contralateral ACP, whereas concha bullosa, middle turbinate hypertrophy, and hyperpneumatized ethmoid bulla favor ipsilateral ACP.
  • Systematic reporting of anatomical variations on CT scans and surgical correction of predisposing factors are recommended.
  • Close monitoring for recurrence in patients with these variations is advised post-surgery.