Sphenochoanal polyp in a child presented with recurrent middle ear effusion: a case report

Abstract

Background Sphenochoanal is a rare benign sinu-nasal lesion. It arises from the sphenoid sinus and passes to the choana then to the nasopharynx. It usually presents with nasal obstruction, discharge, snoring, and headache. It has been reported—only once in the English literature—to cause Eustachian tube dysfunction and middle ear effusion (MEE) in an adult male. In this report, we described an 8-year-old child with a sphenochoanal polyp presented with MEE. Case presentation An 8-year-old boy was referred to us by his family physician with recurrent earache. Otoscopic examination showed MEE on the left side. Anterior rhinoscopy showed a thick grayish discharge in the left nasal cavity. Nasal endoscopic examination showed a polyp in the posterior part of the left nasal cavity obstructing the choana. Computed tomography revealed soft tissue density on the left sphenoid sinus extended to the choana and nasopharynx. Diagnosis of sphenochoanal polyp was established. Endoscopic sinus surgery with removal of the lesion and ventilation tube insertion in the left ear was performed. Histopathologic examination confirmed that the polyp was inflammatory. Follow-up for 1 year showed no recurrence. Conclusions Sphenochoanal which is a rare lesion in children could be a cause of Eustachian tube dysfunction and MEE. Nasal endoscopy and computed tomography are important for diagnosis. We recommend to list sphenochoanal polyp as a cause of Eustachian tube dysfunction and recurrent MEE in children.