Our Summary

This research paper discusses a very rare medical case of osseous metaplasia in a nasal polyp. Osseous metaplasia is a condition in which normal bone forms in soft tissues where it’s not usually found. It’s occasionally seen in different parts of the body such as the ear canal, tongue, gut, stomach, and uterus, but rarely in nasal polyps. In fact, only 12 cases of osseous metaplasia in nasal polyps have been reported in medical literature before.

The paper presents a case where a patient experienced severe nasal obstruction and changes in their voice. A medical examination found a mass in their left nasal cavity that extended to the choanal area and nasopharynx (the area behind the nose that connects to the throat). Scans confirmed the presence of this mass.

The doctors successfully removed the mass through a surgery that went through the nose and mouth. The surgery ensured control of bleeding and complete removal of the mass. After examining the removed mass, it was found to be a benign (non-cancerous) inflammatory polyp with osseous metaplasia. Two years after the surgery, the patient showed no signs of the condition recurring.

This is the first report of such a case where the osseous metaplasia originated from the lateral wall of the nasopharynx, suggesting that this area can also be a site for such unusual transformations. The paper also highlights the effectiveness of the combined endoscopic and transoral surgical approach in managing such cases.

FAQs

  1. What is osseous metaplasia and where is it usually found in the body?
  2. How was the nasal polyp with osseous metaplasia discovered and removed in the patient’s case?
  3. Has the condition recurred in the patient after the surgery?

Doctor’s Tip

A doctor might tell a patient undergoing nasal polyp removal that the surgery will likely involve a combination of endoscopic and transoral approaches to ensure complete removal of the polyp and minimize the risk of recurrence. They may also explain that while osseous metaplasia in nasal polyps is rare, it is important to address it promptly to alleviate symptoms and prevent complications. Additionally, the doctor may discuss the importance of post-operative care and follow-up appointments to monitor for any signs of recurrence.

Suitable For

Patients who are typically recommended nasal polyp removal are those who experience severe nasal obstruction, changes in voice, recurrent sinus infections, or difficulty breathing. In cases where nasal polyps are causing significant symptoms and impacting the patient’s quality of life, surgery may be recommended to remove the polyps and improve nasal airflow. In some cases, nasal polyps may also be removed to investigate the cause of symptoms or to rule out more serious conditions such as cancer.

In the case of osseous metaplasia in a nasal polyp, surgery may be recommended if the patient is experiencing symptoms such as nasal obstruction or changes in voice. This rare condition may require surgical removal to alleviate symptoms and prevent complications.

Overall, the decision to recommend nasal polyp removal will depend on the individual patient’s symptoms, medical history, and the underlying cause of the polyps. It is important for patients to discuss their symptoms and treatment options with a qualified healthcare provider to determine the best course of action for their specific case.

Timeline

Before the nasal polyp removal:

  • Patient experiences severe nasal obstruction and changes in voice
  • Medical examination reveals a mass in the left nasal cavity extending to the choanal area and nasopharynx
  • Scans confirm the presence of the mass

After the nasal polyp removal:

  • Surgery is performed through the nose and mouth to remove the mass
  • Mass is identified as a benign inflammatory polyp with osseous metaplasia
  • Two years post-surgery, the patient shows no signs of recurrence
  • The case is reported as the first of its kind originating from the lateral wall of the nasopharynx
  • Effectiveness of combined endoscopic and transoral surgical approach is highlighted

What to Ask Your Doctor

Some questions a patient should ask their doctor about nasal polyp removal include:

  1. What are the risks and potential complications of the surgery?
  2. What is the expected recovery time after the surgery?
  3. Will I need any follow-up appointments or treatments after the surgery?
  4. How likely is it that the nasal polyps will return after removal?
  5. Are there any lifestyle changes or medications I should consider to prevent the recurrence of nasal polyps?
  6. Will the surgery affect my sense of smell or taste?
  7. How will the surgery impact my ability to breathe through my nose?
  8. Will I need any pain management medication after the surgery?
  9. Are there any specific post-operative care instructions I should follow?
  10. What is the likelihood of complications such as infection or bleeding after the surgery?

Reference

Authors: Testa D, Nunziata M, Romano ML, Massimilla EA, Toni G, De Cristofaro G, Marcuccio G, Motta G. Journal: Am J Case Rep. 2020 Mar 30;21:e921494. doi: 10.12659/AJCR.921494. PMID: 32225129