Aural polyps: Safe or unsafe disease?

Purpose: To determine whether a case of inflammatory aural polyp constitutes a safe or unsafe disease and to arrive at the most suitable treatment option. Design: Prospective study. Follow-up period of 6 months. Setting: Hospitalized treatment in a tertiary medical college hospital that provides care for a predominantly rural population. Patients: All patients treated for aural polyp, having a postoperative histopathological diagnosis of inflammatory aural polyp. Most patients (72%) belonged to the lower middle class. Results: Forty-two patients treated during a 4-year-period were analyzed. Eleven cases were treated by simple aural polypectomy, of which 78% had either recurrence or persistent disease. Out of 31 patients who underwent mastoid exploration, 52% had extensive disease of the mastoid air-cell system and 35% had an underlying cholesteatoma. Six percent had persistent discharge. The disease was often associated with complications (19%). Conclusions: The presence of an aural polyp signifies well-established disease of the middle ear cleft with a greater potential for complications and often obscures an underlying cholesteatoma. We propose that all cases of aural polyps should be considered as unsafe disease and subjected to a formal mastoid exploration.