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Nasal Polyps Gradings

                       Grade I                                             Grade II

                       Grade III                                        Grade IV     


 Glistening and pale growth aliken to peel grape appearance are characteristic features of nasal polyps.  It is painless and can be quite mobile on probing as compared to nasal turbinates. 


Grading of nasal polyps (Based on Hadley's clinical scoring system of nasal polyposis):


Grade 1: smallest size polyps within the middle meatus not reaching the   inferior edge of the middle turbinate).

Grade 2: polyps within the middle meatus reaching the inferior border of the middle turbinate.

Grade 3: polyps extending into the nasal cavity below the edge of the middle turbinate but not below the inferior edge of the inferior turbinate.

Grade 4: polyps filling up the nasal cavity


Close-up view of nasal polyp (P).  Compare it with the inferior turbinate appearance (IT).





Suggested reading


Unilateral nasal polyp extruding and completely obstructing the right nostril.

Nasal polyps with chronic sinusitis. Note mucopus in the nasal cavity

and copius postnasal drip seen in the oropharynx.


Watch video of nasal polyps @ YouTube

Video 1                    Video 2

Ethmoidal Nasal Polyps

Early Polyp Emerging From Accessory Ostium

Antrochoanal Polyp

Unilateral polyp arising from right antral mucosa surface (+), enlarging slowly, and finally extrude into middle meatus via accessory meatus (arrow).  [MT - middle meatus, S - nasal septum]

Antrochoanal Polyp: The Established Stage [Dumb-Bell]


                        Figure 1                                                 Figure 2 


                           Figure 3                                             Figure 4


Antrochoanal polyp means a polyp arising from the antral mucosa and extending into the posterior choana (dumb bell-shaped) after its exit usually through the accessory ostium. 


Figure 1: origin and attachment of polyp from antral mucosa.

Figure 2: polyp after its exits from left maxillary accessory ostium

Figure 3: posterior extension of polyp into the postnasal space as seen through right nasal cavity

Figure 4: occasionally, longstanding polyp can be seen behind the soft palate or even in the oropharynx


CT-scan usually shows an opacified maxillary sinus on the affected side with soft tissue opacity extending into the nasopharynx.


Watch video of antrochoanal polyp @ YouTube

Polyps Specimen