Nasopharyngeal Hairy Polyp Causing Pediatric Sleep-Disordered Breathing

A rare congenital nasopharyngeal hairy polyp was incidentally identified during an attempted adenoidectomy in a 15-month-old female. The patient presented with snoring and intermittent apnea concerning for upper airway obstruction. Magnetic resonance imaging (MRI) revealed a 2.5-cm partially enhancing nasopharyngeal mass along the soft palate, likely originating near the left nasopharyngeal wall or Eustachian tube orifice. The lesion was excised transorally without complications. Histopathological analysis confirmed a benign hairy polyp composed of mature adipose tissue, skeletal muscle, and cartilage, lined by keratinized squamous epithelium with underlying adnexa including pilosebaceous units. Postoperatively, the patient’s symptoms resolved. Interval postoperative MRI surveillance is planned for 6 months. This case highlights the importance of considering rare congenital lesions within the differential diagnosis of pediatric obstructive sleep symptoms. Early recognition and diagnosis can lead to appropriate surgical planning and better outcomes for these patients.