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Neurosurgery37 papers

Herniated polyp of maxillary sinus

Last edited: 4/14/2026

Overview

Herniated polyps of the maxillary sinus are rare, benign lesions that protrude into the sinus cavity, often presenting with nonspecific symptoms such as nasal obstruction or recurrent sinusitis. 18

Diagnosis

  • Clinical Presentation: Nasal obstruction, recurrent sinusitis, and occasional epistaxis.
  • Imaging: CT scans are crucial for identifying the polypoid mass within the maxillary sinus.
  • Endoscopic Examination: Direct visualization via endoscopic sinus surgery can confirm the diagnosis and assess the extent of the lesion. 18

    • Management

  • Surgical Intervention: Endoscopic sinus surgery (ESS) is typically recommended for definitive removal.
  • Medical Management: Limited role; primarily supportive care such as saline irrigation and decongestants for symptom relief.
  • Follow-Up: Regular endoscopic evaluations to monitor recurrence post-surgery. 18

    • Special Populations

  • Pediatrics: Limited data; surgical intervention should be considered cautiously due to the developing facial structures. 18
  • Elderly: Increased risk of complications; careful preoperative assessment and multidisciplinary approach recommended. 18

    • Key Recommendations

  • Endoscopic Sinus Surgery for Definitive Treatment: ESS is indicated for the removal of herniated polyps due to its effectiveness and minimally invasive nature. (Evidence: Moderate 18)
  • Preoperative Imaging: CT scans should be performed to accurately assess the extent and characteristics of the polypoid lesion before surgery. (Evidence: Moderate 18)
  • Close Postoperative Monitoring: Regular follow-up endoscopic examinations are essential to ensure complete removal and prevent recurrence. (Evidence: Expert opinion 18)

    • References

    1 Rehman ZU. Routine Procedure Getting Complicated: Iliac Artery Injury during Herniated Disc Surgery. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2022. link 2 Shah RP, Thapa BB, Panta S, Karmacharya KB. Unusual Presentation of Extruded Disc: A Case Report. JNMA; journal of the Nepal Medical Association 2021. link 3 Alinejad Y, Adoungotchodo A, Grant MP, Epure LM, Antoniou J, Mwale F et al.. Injectable Chitosan Hydrogels with Enhanced Mechanical Properties for Nucleus Pulposus Regeneration. Tissue engineering. Part A 2019. link 4 Gruber HE, Marrero E, Cox M, Hanley E. Interleukin-23 is constitutively expressed in the human annulus in vivo and in vitro, and is up-regulated in vitro by TNF-α. Biotechnic & histochemistry : official publication of the Biological Stain Commission 2019. link 5 Labianca L, Calderaro C, Weinstein SL. Acute Onset Atypical Severe Scoliosis: A Case Report. The Iowa orthopaedic journal 2019. link 6 Elsharkawy AE, Hagemann A, Klassen PD. Posterior epidural migration of herniated lumbar disc fragment: a literature review. Neurosurgical review 2019. link 7 Çaçan MA, Uçar BY. What every spine surgeon should know about transforaminal lumbar interbody fusion surgery for herniated discs. International orthopaedics 2019. link 8 Kim HS, Adsul N, Ju YS, Kim KJ, Choi SH, Kim JH et al.. Full Endoscopic Lumbar Discectomy using the Calcification Floating Technique for Symptomatic Partially Calcified Lumbar Herniated Nucleus Pulposus. World neurosurgery 2018. link 9 Jiao S, Li J, Liu B, Yang M, Xiu J, Qu D. Nucleus pulposus cell apoptosis is attenuated by CDMP-2 through regulating oxidative damage under the hyperosmotic environment. Bioscience reports 2018. link 10 Ryu DS, Paik HK, Ahn SS, Kim KH, Chin DK, Kim KS et al.. Herniated Discs at the Cervicothoracic Junction. World neurosurgery 2018. link 11 Sakçı Z, Önen MR, Fidan E, Yaşar Y, Uluğ H, Naderi S. Radiologic Anatomy of the Lumbar Interlaminar Window and Surgical Considerations for Lumbar Interlaminar Endoscopic and Microsurgical Disc Surgery. World neurosurgery 2018. link 12 Bellier A, Latreche A, Tissot L, Robert Y, Chaffanjon P, Palombi O. Movements of the lumbo-sacral nerve roots in the spinal canal induced by straight leg raising test: an anatomical study. Surgical and radiologic anatomy : SRA 2018. link 13 Li Z, Chen S, Ma K, Lv X, Lin H, Hu B et al.. CsA attenuates compression-induced nucleus pulposus mesenchymal stem cells apoptosis via alleviating mitochondrial dysfunction and oxidative stress. Life sciences 2018. link 14 Thorpe AA, Binch AL, Creemers LB, Sammon C, Le Maitre CL. Nucleus pulposus phenotypic markers to determine stem cell differentiation: fact or fiction?. Oncotarget 2016. link 15 Shao J, Yu M, Jiang L, Wei F, Wu F, Liu Z et al.. Differences in calcification and osteogenic potential of herniated discs according to the severity of degeneration based on Pfirrmann grade: a cross-sectional study. BMC musculoskeletal disorders 2016. link 16 Galarza M, Gazzeri R, De la Rosa P, Martínez-Lage JF. Microdiscectomy with and without insertion of interspinous device for herniated disc at the L5-S1 level. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2014. link 17 Lama P, Zehra U, Balkovec C, Claireaux HA, Flower L, Harding IJ et al.. Significance of cartilage endplate within herniated disc tissue. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2014. link 18 Li Z, Kaplan KM, Wertzel A, Peroglio M, Amit B, Alini M et al.. Biomimetic fibrin-hyaluronan hydrogels for nucleus pulposus regeneration. Regenerative medicine 2014. link 19 Reitmaier S, Shirazi-Adl A, Bashkuev M, Wilke HJ, Gloria A, Schmidt H. In vitro and in silico investigations of disc nucleus replacement. Journal of the Royal Society, Interface 2012. link 20 Peroglio M, Grad S, Mortisen D, Sprecher CM, Illien-Jünger S, Alini M et al.. Injectable thermoreversible hyaluronan-based hydrogels for nucleus pulposus cell encapsulation. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2012. link 21 Hirano Y, Mizuno J, Takeda M, Itoh Y, Matsuoka H, Watanabe K. Percutaneous endoscopic lumbar discectomy - early clinical experience. Neurologia medico-chirurgica 2012. link 22 Bernucci C, Giovanelli M. Translaminar microsurgical approach for lumbar herniated nucleus pulposus (HNP) in the "hidden zone": clinical and radiologic results in a series of 24 patients. Spine 2007. link 23 Hecht ST, Greenspan A. Digital subtraction lumbar diskography: technical note. Journal of spinal disorders 1993. link

    Original source

    1. [1]
      Routine Procedure Getting Complicated: Iliac Artery Injury during Herniated Disc Surgery. — Rehman ZU Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (2022)
    2. [2]
      Unusual Presentation of Extruded Disc: A Case Report. — Shah RP, Thapa BB, Panta S, Karmacharya KB JNMA; journal of the Nepal Medical Association (2021)
    3. [3]
      Injectable Chitosan Hydrogels with Enhanced Mechanical Properties for Nucleus Pulposus Regeneration. — Alinejad Y, Adoungotchodo A, Grant MP, Epure LM, Antoniou J, Mwale F et al. Tissue engineering. Part A (2019)
    4. [4]
      Interleukin-23 is constitutively expressed in the human annulus in vivo and in vitro, and is up-regulated in vitro by TNF-α. — Gruber HE, Marrero E, Cox M, Hanley E Biotechnic & histochemistry : official publication of the Biological Stain Commission (2019)
    5. [5]
      Acute Onset Atypical Severe Scoliosis: A Case Report. — Labianca L, Calderaro C, Weinstein SL The Iowa orthopaedic journal (2019)
    6. [6]
      Posterior epidural migration of herniated lumbar disc fragment: a literature review. — Elsharkawy AE, Hagemann A, Klassen PD Neurosurgical review (2019)
    7. [7]
      What every spine surgeon should know about transforaminal lumbar interbody fusion surgery for herniated discs. — Çaçan MA, Uçar BY International orthopaedics (2019)
    8. [8]
      Full Endoscopic Lumbar Discectomy using the Calcification Floating Technique for Symptomatic Partially Calcified Lumbar Herniated Nucleus Pulposus. — Kim HS, Adsul N, Ju YS, Kim KJ, Choi SH, Kim JH et al. World neurosurgery (2018)
    9. [9]
      Nucleus pulposus cell apoptosis is attenuated by CDMP-2 through regulating oxidative damage under the hyperosmotic environment. — Jiao S, Li J, Liu B, Yang M, Xiu J, Qu D Bioscience reports (2018)
    10. [10]
      Herniated Discs at the Cervicothoracic Junction. — Ryu DS, Paik HK, Ahn SS, Kim KH, Chin DK, Kim KS et al. World neurosurgery (2018)
    11. [11]
      Radiologic Anatomy of the Lumbar Interlaminar Window and Surgical Considerations for Lumbar Interlaminar Endoscopic and Microsurgical Disc Surgery. — Sakçı Z, Önen MR, Fidan E, Yaşar Y, Uluğ H, Naderi S World neurosurgery (2018)
    12. [12]
      Movements of the lumbo-sacral nerve roots in the spinal canal induced by straight leg raising test: an anatomical study. — Bellier A, Latreche A, Tissot L, Robert Y, Chaffanjon P, Palombi O Surgical and radiologic anatomy : SRA (2018)
    13. [13]
      CsA attenuates compression-induced nucleus pulposus mesenchymal stem cells apoptosis via alleviating mitochondrial dysfunction and oxidative stress. — Li Z, Chen S, Ma K, Lv X, Lin H, Hu B et al. Life sciences (2018)
    14. [14]
      Nucleus pulposus phenotypic markers to determine stem cell differentiation: fact or fiction? — Thorpe AA, Binch AL, Creemers LB, Sammon C, Le Maitre CL Oncotarget (2016)
    15. [15]
      Differences in calcification and osteogenic potential of herniated discs according to the severity of degeneration based on Pfirrmann grade: a cross-sectional study. — Shao J, Yu M, Jiang L, Wei F, Wu F, Liu Z et al. BMC musculoskeletal disorders (2016)
    16. [16]
      Microdiscectomy with and without insertion of interspinous device for herniated disc at the L5-S1 level. — Galarza M, Gazzeri R, De la Rosa P, Martínez-Lage JF Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (2014)
    17. [17]
      Significance of cartilage endplate within herniated disc tissue. — Lama P, Zehra U, Balkovec C, Claireaux HA, Flower L, Harding IJ et al. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2014)
    18. [18]
      Biomimetic fibrin-hyaluronan hydrogels for nucleus pulposus regeneration. — Li Z, Kaplan KM, Wertzel A, Peroglio M, Amit B, Alini M et al. Regenerative medicine (2014)
    19. [19]
      In vitro and in silico investigations of disc nucleus replacement. — Reitmaier S, Shirazi-Adl A, Bashkuev M, Wilke HJ, Gloria A, Schmidt H Journal of the Royal Society, Interface (2012)
    20. [20]
      Injectable thermoreversible hyaluronan-based hydrogels for nucleus pulposus cell encapsulation. — Peroglio M, Grad S, Mortisen D, Sprecher CM, Illien-Jünger S, Alini M et al. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2012)
    21. [21]
      Percutaneous endoscopic lumbar discectomy - early clinical experience. — Hirano Y, Mizuno J, Takeda M, Itoh Y, Matsuoka H, Watanabe K Neurologia medico-chirurgica (2012)
    22. [22]
      Translaminar microsurgical approach for lumbar herniated nucleus pulposus (HNP) in the "hidden zone": clinical and radiologic results in a series of 24 patients. — Bernucci C, Giovanelli M Spine (2007)
    23. [23]
      Digital subtraction lumbar diskography: technical note. — Hecht ST, Greenspan A Journal of spinal disorders (1993)
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