Ethmodial Nasal polyps are?

a. Infective origin
b.Allergic origin.
c.Neoplastic origin.
d. Idiopathic.

Ans: B 

Ethmoidal polyps are multiple, bilateral, painless, pearly white, grape like masses arising from the ethmoidal air cells.Ethmoidal air cells are multiple air cells present on medial to the eyes. 

Usually allergic origin 

These polyps are multiple, bilateral and have a grape like appearance. They have a strong allergic co-relation. 

Symptoms: 

Nasal obstruction: This is usually bilateral. 

Anosmia(Loss of sensation of smell) 

Watery nasal discharge 

Headache also called "Vacuum Headache" 

Watering of the eyes-Epiphora due to blockage of nasolacrimal duct 

Sneezing is common as these polyps are allergic in origin. 

Clinical signs: 

Hyponasal voice (Rhinolalia Clausa) is present due to bilateral nasal obstruction. 

Broadening of nasal bridge. 

Medical Treatment: 

Antihistaminics, low dose steroids, local steroid sprays, help to regress the ethmoidal polyps to a certain extent. However, the above treatment rarely eliminates well formed polyps and is often combined with surgery. 

Surgical Treatment: 

Functional Endoscopic Sinus Surgery (FESS): Ethmoidectomy and polypectomy using FESS and microdebrider has considerably reduced the incidence of recurrence. 

Ethmoidectomy: It can be done, external or transantral. However, it is not commonly done. 

Polypectomy using nasal snare was used. However it is not commonly done these days due to higher chances of recurrence, and residual disease left behind.