Polypoid Change of the Middle Turbinate and Paranasal Sinus Polyposis Are Distinct Entities

Abstract

Objectives Polypoid change of the middle turbinate (PCMT) is a finding on intranasal examination whose significance is not well understood. We present a comparison of the clinical characteristics of PCMT with paranasal sinus polyposis (PSP), a common condition with potentially similar appearance. Study Design Parallel case series. Setting Tertiary rhinology clinic. Subjects and Methods Data were prospectively compiled from consecutive patients during a 12-month period with either PSP arising from the middle meatus or PCMT limited to the middle turbinate as identified on nasal endoscopy. Recorded data included comorbidities, the 22-item Sinonasal Outcome Test (SNOT-22), Nasal Obstruction Symptom Evaluation (NOSE), Lund-Mackay score from computed tomography (CT) imaging, and total eosinophil levels. Results Of 593 patients, 23 (3.9%) had PCMT and 44 (7.4%) had PSP. The PSP group was predominantly male (75% vs 52%, P < .001) with an older mean age (53.4 vs 35.4 years, P < .0001). PCMT was more often associated with allergic rhinitis (83% vs 34%, P < .001), whereas PCMT was rarely associated with chronic rhinosinusitis (10% vs 100%, P < .0001). Mean eosinophil count (7.1 vs 3.1, P = .096) was not significantly different between groups, whereas mean Lund-Mackay score was higher in PSP (14.9 vs 2.8, P < .0008). Mean NOSE score was greater in PSP (65.3 vs 46.8, P = .025), whereas SNOT-22 score was comparable between groups (40.6 vs 34.6, P = .29). Conclusion PCMT is a unique physical finding with clinical associations that distinguish it from PSP. PCMT has greater association with allergic rhinitis than chronic rhinosinusitis, and both PCMT and PSP are associated with impaired quality of life.